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General NPI Number Information
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NPI Number | 1881135804
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Entity Type | Individual
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Provider Name | GREGORY J BRADLEY D.O
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Gender | Male
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 4500 S GARNETT RD STE 112
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City | TULSA
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State | OK
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Zip | 74146-5201
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Country | US
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Telephone | 918-935-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 S GARNETT RD STE 112
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City | TULSA
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State | OK
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Zip | 74146-5201
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Country | US
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Telephone | 918-935-3550
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 6368
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 77075
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 6368
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License Number State | OK
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