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Contact Information

STEPHEN K BRADLEY, MD
1795 S DEVONSHIRE DR
SALT LAKE CITY, UT84108-2562
 Phone: 801-860-5905
 Fax: 855-242-1691
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for STEPHEN K BRADLEY · (Male)

NPI # 1508950296
Status Active
Credentials MD
Entity Individual
Enumeration date 10/03/2006
Last updated 04/21/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 172488-1205
  • AZ Medicaid 820771
  • ID Medicaid 806727300
  • NV Medicaid 002086464
  • WY Medicaid 103500200
  • UT Other QM0000075886 ALTIUS
  • UT Other 17839 DESERET MUTUAL
  • UT Other 870545614SB3 EDUCATORS MUTUAL
  • UT Other 44140 HEALTHY U
  • UT Other 107006512102 IHC
  • UT Other PRA07396 MOLINA
  • UT Other 73544 PEHP
  • UT Other 1502954 UMWA
  • UT Other 2090168 UNITED HEALTHCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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