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Individual

DR. JEREMY L BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
(270) 684-7711
(270) 684-7753
Mailing address
3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
(270) 684-7711
(270) 684-7753

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31984
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000075315
BC/BS
KY
05
64319841
KY
Enumeration date
09/29/2006
Last updated
02/28/2024
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