Allen, Bradley A

Allen, Bradley A is an individual health care provider with primary practice located at 130 Corporate Dr , Beaver Dam WI 53916-3116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Allen, Bradley A can be contacted via phone (920) 887-3102.

Contact Information

Primary practice address
130 Corporate Dr Beaver Dam WI 53916-3116
Phone: (920) 887-3102
Fax: (920) 855-8790
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35870-020 Wisconsin

Profile Details

NPI number 1447201918
LBN Legal business name Allen, Bradley A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Mar 1st, 2021 - about 3 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 1447201918 NPPES
Wisconsin MEDICAID 1447201918

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