Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 35049656 | OH |
NPI | 1023455441 |
---|---|
Provider Name | Dr. John F Bradley |
First Address | Columbus, OH 43215-2241 |
Second Address | Columbus, OH 43215-2241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2013 |
Last Update Date | 24/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0616604 | (05) | OH |
A16498 | (02) | OH |