Kevin G. Bradley P.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

3321 Issued in OK

Legal business name

KEVIN G. BRADLEY P.C.

Doing business as

Professional Office of Dr Kevin G Bradley PC,Inc

Practice address

640 Alexander Dr Ste 107
Eufaula, OK 74432-4013

Phone

(918) 689-2424

Fax

(918) 618-4778

NPI assigned

Sep 20, 2006

Last updated

Mar 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Garner Bradley, D.C.NPI 1609971241

Title

President/Owner

Phone

(918) 689-2424

Specialties & licenses 1

Addresses

Other names 1

• Professional Office of Dr Kevin G Bradley PC,Inc Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin G. Bradley, CH

  • Sports Physician Chiropractor
  • Eufaula, OK
  • NPI 1609971241
  Authorized official Same address or phone
• Patricia G Smith, ARNP, FNP-C

  • Family Nurse Practitioner
  • Indianola, OK
  • NPI 1770060147
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1922106590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 930",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744320930",
            "telephone_number": "918-689-2424",
            "fax_number": "918-618-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ALEXANDER DR STE 107",
            "city": "EUFAULA",
            "state": "OK",
            "postal_code": "744324013",
            "telephone_number": "918-689-2424",
            "fax_number": "918-618-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN G. BRADLEY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "GARNER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "918-689-2424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "OK",
            "license": "3321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Office of Dr Kevin G Bradley PC,Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Physician Chiropractor in Eufaula, OK
• Providers in Eufaula, OK by specialty
• Sports Physician Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.