Individual
BRADLEY KEITH BITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 S MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63703-4914
(573) 331-5544
(573) 331-5545
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2006023028
MO
207RS0012X
Sleep Medicine (Internal Medicine) Physician
2006023028
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165391001
—
AR
05
—
1760476519
—
IL
05
—
200387790
—
IN
05
—
206881716
—
MO
01
—
248625
HEALTHLINK
MO
01
—
536594
ANTHEM BCBS
MO
05
—
7100095140
—
KY
01
—
P00382733
RR MCR
MO
Enumeration date
09/08/2005
Last updated
12/29/2020
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