Individual
DR. BRADLEY G TITUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8111
Mailing address
PO BOX 1398, WALLA WALLA, WA 99362-0309
(509) 527-8154
(509) 527-8010
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00024594
WA
207RI0011X
Interventional Cardiology Physician
MD00024594
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2012756
—
WA
Enumeration date
08/17/2005
Last updated
10/01/2020
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