Individual
DR. ADAM DEREK BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
802 S JACKSON AVE, #505, TULSA, OK 74127-9015
(918) 747-5322
Mailing address
802 S JACKSON AVE STE 505, TULSA, OK 74127-9060
(918) 747-5322
(918) 746-7604
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5188
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200449100A
—
OK
Enumeration date
05/02/2011
Last updated
02/12/2019
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