Davis, Bradley Carl

Davis, Bradley Carl is an individual health care provider with primary practice located at 1305 Lakeland Hills Blvd , Lakeland FL 33805-4542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Davis, Bradley Carl can be contacted via phone (863) 688-2334.

Contact Information

Primary practice address
1305 Lakeland Hills Blvd Lakeland FL 33805-4542
Phone: (863) 688-2334
Fax: (863) 577-1160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 50439 Arizona
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 50439 Arizona
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME146799 Florida

Profile Details

NPI number 1801026893
LBN Legal business name Davis, Bradley Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2009
Last updated Apr 2nd, 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 1801026893 NPPES
Arizona MEDICAID 018841

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