Healthcare Provider Details

I. General information

NPI: 1134407133
Provider Name (Legal Business Name): BRADLEY ROBERT PIERCE P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 FARSON ST STE 210
BELPRE OH
45714-1069
US

IV. Provider business mailing address

2165 MEDICAL PARK DR
HICKORY NC
28602-8809
US

V. Phone/Fax

Practice location:
  • Phone: 740-376-5000
  • Fax: 740-401-0430
Mailing address:
  • Phone: 828-324-2800
  • Fax: 828-294-9160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12541
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.003359RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: