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Individual

ERIC W. BRADBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
475 SHOPPERS DR, WINCHESTER, KY 40391-1380
(859) 744-5111
(859) 744-1177
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7840
(606) 330-7825

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35962
KY
208000000X
Pediatrics Physician
35962
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6400
MEDICARE GROUP NUMBER
KY
05
64068257
KY
Enumeration date
05/25/2006
Last updated
05/07/2019
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