Individual
DR. KIMBERLY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, JBSA LACKLAND, TX 78236
(210) 292-9441
Mailing address
1100 WILFORD HALL LOOP, BLDG 4554, ATTN: 59 MDW/SGHC, JBSA LACKLAND, TX 78236-9908
(210) 292-6225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
230
NE
2083A0100X
Aerospace Medicine Physician
Primary
230
NE
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
230
NE
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
230
NE
Other
Enumeration date
12/08/2005
Last updated
08/17/2018
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