Individual
DR. J DOUGLAS BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4117 N ELIZABETH ST, PUEBLO, CO 81008-2009
(719) 545-0788
(719) 545-0787
Mailing address
3190 BRECKENRIDGE DR W, COLORADO SPRINGS, CO 80906-4539
(719) 540-5655
(719) 540-5655
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35663
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01356633
—
CO
Enumeration date
02/06/2007
Last updated
07/08/2007
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