Healthcare Provider Details

I. General information

NPI: 1295232957
Provider Name (Legal Business Name): BRADLEY DAVID ROCKWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SHAWNEE MISSION PKWY
WESTWOOD KS
66205-2003
US

IV. Provider business mailing address

565 COAL VALLEY RD
JEFFERSON HILLS PA
15025-3703
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 412-267-6810
  • Fax: 412-267-6817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD474105
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number04-54090
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number04-54090
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: