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General NPI Number Information
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NPI Number | 1801475447
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Entity Type | Individual
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Provider Name | BRADLEY WILLIAM EMMERICH MD
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Gender | Male
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1900 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5467
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Country | US
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Telephone | 608-782-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5467
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Country | US
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Telephone | 608-782-7300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4351047937
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 78053
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD-53766
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 83274-20
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License Number State | WI
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