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Contact Information

MICHAEL B BRADLEY, MD
3185 W STATE ST
SUITE 2010
BRISTOL, TN37620-1610
 Phone: 423-968-7555
 Fax: 423-968-7641
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for MICHAEL B BRADLEY · (Male)

NPI Number 1457461733
Status Active
Credentials MD
Entity Individual
Enumeration date 08/30/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • TN License # 29086
  • VA License # 0101056321
  • TN Other 3064606 BLUE CROSS BLUE SHIELD
  • VA Other 382476 ANTHEM
Hospital affiliation(s)
  • WELLMONT BRISTOL REGIONAL MEDICAL CENTER - (Acute Care)
    ONE MEDICAL PARK BLVD
    BRISTOL, TN 37620
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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