Bradley, Rickey Lee

Bradley, Rickey Lee is an individual health care provider with primary practice located at 4130 Robert C Byrd Dr , Beckley WV 25801-2206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bradley, Rickey Lee can be contacted via phone (304) 252-3900.

Contact Information

Primary practice address
4130 Robert C Byrd Dr Beckley WV 25801-2206
Fax: (304) 252-9311
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1741 West Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 1741 West Virginia

Profile Details

NPI number 1700877735
LBN Legal business name Bradley, Rickey Lee
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Nov 6th, 2015 - about 10 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 1700877735 NPPES
West Virginia MEDICAID 005642949

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