Bradley, Robert Andrew
Bradley, Robert Andrew is an sole proprietor health care provider with primary practice located at 235 S Church St , Athens GA 30605-1054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Bradley, Robert Andrew can be contacted via phone (478) 731-9831.Contact Information
Primary practice address
235 S Church St
Athens GA 30605-1054
Phone: (478) 731-9831
Fax: (706) 850-6852
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 025725 | Georgia |
Profile Details
| NPI number | 1164401287 |
|---|---|
| LBN Legal business name | Bradley, Robert Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Oct 29th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164401287 | NPPES |
| Georgia | Other | 58-1267100 | TRICARE |
| Georgia | Other | 07991 | TRICARE |
| Georgia | Other | 345259 | TRICARE |
| Georgia | MEDICAID | 000290056A | TRICARE |
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