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NPI Code Detail

MEDICARE: BRADLEY JOHN CHEEK M.D.

MEDICARE: BRADLEY JOHN CHEEK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD.206694LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3V70756OTHERNVPTAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275774242
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY JOHN CHEEK M.D.
Provider Business Mailing Address
First Line : 7455 W WASHINGTON AVE STE 301
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-4340
Country : US
Telephone Number : 504-842-4000
Fax Number :
Provider Business Practice Location Address
First Line : 7455 W WASHINGTON AVE STE 301
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-4340
Country : US
Telephone Number : 504-842-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2009
Last Update Date : 02/15/2022

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