Coughlin, Bradley Philip
Coughlin, Bradley Philip is an individual health care provider with primary practice located at 2767 Janitell Rd , Colorado Springs CO 80906-4102. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Coughlin, Bradley Philip can be contacted via phone (719) 365-2888.Contact Information
Primary practice address
2767 Janitell Rd
Colorado Springs CO 80906-4102
Phone: (719) 365-2888
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 0110002173 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2850 | Colorado |
Profile Details
| NPI number | 1053399451 |
|---|---|
| LBN Legal business name | Coughlin, Bradley Philip |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2006 |
| Last updated | May 12th, 2020 - about 6 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 | 1053399451 | NPPES |
| Virginia | Other | TN0141 | JOHN DEERE HEALTH |
| Virginia | MEDICAID | 010213355 | JOHN DEERE HEALTH |
| Virginia | Other | P00306338 | JOHN DEERE HEALTH |
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