Healthcare Provider Details

I. General information

NPI: 1316901010
Provider Name (Legal Business Name): BRADLEY LEONARD ZINK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 08/09/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N 4TH ST SUITE B
ODESSA MO
64076-1646
US

IV. Provider business mailing address

408 N 4TH ST SUITE B
ODESSA MO
64076-1646
US

V. Phone/Fax

Practice location:
  • Phone: 816-230-8777
  • Fax: 816-230-8855
Mailing address:
  • Phone: 816-230-8777
  • Fax: 816-230-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOR9F95
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: