Healthcare Provider Details

I. General information

NPI: 1215558218
Provider Name (Legal Business Name): ALEC L BRADLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 MAIN ST
HAMILTON OH
45013-1605
US

IV. Provider business mailing address

500 S PRESTON ST RM 305
LOUISVILLE KY
40202-1702
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-2181
  • Fax: 513-868-2893
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.155863
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberR6382
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: