Individual
DR. BRADLEY SCOTT LITKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 SAINT MARYS DR STE 300, EVANSVILLE, IN 47714-0521
(812) 473-2642
Mailing address
901 SAINT MARYS DR STE 300, EVANSVILLE, IN 47714-0521
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME76130
FL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01080295A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
ME76130
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2544997
—
FL
01
—
266180C35
TRADITIONAL MEDICARE
IN
05
—
300017621
—
IN
01
—
P02110464
MEDICARE RR
IN
Enumeration date
09/19/2005
Last updated
07/19/2022
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