Individual
DR. BRADLEY S OLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 ZORN AVE DEPT OF, LOUISVILLE, KY 40206-1433
(502) 287-5090
Mailing address
2120 CONTEMPORARY LN, CRESTWOOD, KY 40014-6769
(502) 376-5886
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38168
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057464
ANTHEM ID#
KY
01
—
50006762
PASSPORT ID#
KY
05
—
64047046
—
KY
Enumeration date
01/13/2006
Last updated
08/21/2024
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