Bradley, Ryan

Bradley, Ryan is an individual health care provider with primary practice located at 6600 Van Aalst Blvd , Fort Moore GA 31905-2102. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Bradley, Ryan can be contacted via phone (915) 742-2273.

Contact Information

Primary practice address
6600 Van Aalst Blvd Fort Moore GA 31905-2102
Phone: (915) 742-2273
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1198847 Texas
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 9118992 Florida

Profile Details

NPI number 1235862012
LBN Legal business name Bradley, Ryan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2022
Last updated Jul 18th, 2024 - about 2 months 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 1235862012 NPPES
New Mexico Other 514764972 STATE DRIVERS LICENSE

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