Organization
MARK S. BRADLEY, M.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S BRADLEY M.D. (OWNER/PHYSICIAN)
(505) 466-2575
Entity
Organization
Contact information
Practice address
2015 GALISTEO ST, SANTA FE, NM 87505-2101
(505) 466-2575
(505) 989-1550
Mailing address
2015 GALISTEO ST, SANTA FE, NM 87505-2101
(505) 466-2575
(505) 989-1550
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2002-0015
NM
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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