Individual
DR. JOHN STEVEN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
(913) 789-3106
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
(913) 789-3106
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32784
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801018536
—
MO
05
—
200564180A
—
KS
05
—
200564180B
—
KS
01
—
40359018
BCBS KCMO SMMC EMERGENCY PHYSICIANS GROUP 01674018
—
01
—
40359028
BCBS KCMO ER PHYSICIANS SOUTH PA GROUP 30492021
—
01
—
P00635002
RR MEDICARE GROUP CG8899
KS
01
—
P00681220
RR MEDICARE NUMBER FOR GROUP DC6712
KS
Enumeration date
05/03/2007
Last updated
06/29/2021
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