Bradshaw, Bascom Kyle

Bradshaw, Bascom Kyle is an individual health care provider with primary practice located at 2191 E Johnson Ave , Pensacola FL 32514-6029. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Aerospace Medicine. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Bradshaw, Bascom Kyle can be contacted via phone (850) 494-3917.

Contact Information

Primary practice address
2191 E Johnson Ave Pensacola FL 32514-6029
Phone: (850) 494-3917
Fax: (850) 494-3960
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X DO.1388 Alabama
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 02002502A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 73929 Georgia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 2018-01630 North Carolina
Allopathic & Osteopathic Physicians / Aerospace Medicine 2083A0100X 02002502A Indiana
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X OS16451 Florida

Profile Details

NPI number 1518064583
LBN Legal business name Bradshaw, Bascom Kyle
Credentials D.O., M.P.H.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Feb 1st, 2023 - about 2 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 1518064583 NPPES
North Carolina MEDICAID 1518064583

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