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
Fax: (706) 850-6852
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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