Organization
BRADLEY PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL FOSTER (EXECUTIVE DIRECTOR, FINANCIAL SERVI)
(706) 272-6124
Entity
Organization
Contact information
Practice address
2305 CHAMBLISS AVE NW, CLEVELAND, TN 37311-3847
(423) 728-1650
Mailing address
PO BOX 1900, DALTON, GA 30722-1900
(423) 728-1650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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