Healthcare Provider Details

I. General information

NPI: 1285848283
Provider Name (Legal Business Name): BRADLEY G JONES P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44344 DEQUINDRE RD STE 360
STERLING HEIGHTS MI
48314-1041
US

IV. Provider business mailing address

44344 DEQUINDRE RD STE 360
STERLING HEIGHTS MI
48314-1041
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-0707
  • Fax: 586-254-7507
Mailing address:
  • Phone: 586-254-0707
  • Fax: 586-254-7507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601003603
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: