R Ralph Bradley M D PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

162090-1205 Issued in UT

Legal business name

R RALPH BRADLEY M D PC

Practice address

166 E 5900 S
B-111
Murray, UT 84107-7257

Phone

(801) 268-9672

Fax

(801) 266-9390

NPI assigned

Jan 20, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ralph Bradley, M.D.

Title

Owner

Phone

(801) 268-9672

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matt Scott Francom, PA-C

  • Physician Assistant
  • West Point, UT
  • NPI 1598910101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1396982930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E 5900 S",
            "address_2": "B-111",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077257",
            "telephone_number": "801-268-9672",
            "fax_number": "801-266-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E 5900 S",
            "address_2": "B-111",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077257",
            "telephone_number": "801-268-9672",
            "fax_number": "801-266-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R RALPH BRADLEY M D PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-268-9672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "162090-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529622566001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Joseph Quackenbush, C.S.W.
• Dawn Ranae Quada, DNP, APRN, FNP-C
• Audrey Quealy
• Jeffrey Dennis Quinn, MD
• Fernando Quintero
• R Scott Haupt MD PC
• Andrew Keller Rabley, M.D.
• Rachel Jenkins-Lloyd, Aprn
• Skylar Rackham, PA-C
• Terri Rackley

• Dermatology Physician in Murray, UT
• Providers in Murray, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.