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General NPI Number Information
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NPI Number | 1891778403
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Entity Type | Individual
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Provider Name | BRADLEY JOSEPH CLARKE D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 4040 EMBASSY PKWY STE 370
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City | AKRON
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State | OH
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Zip | 44333-8372
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Country | US
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Telephone | 234-466-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 2942 TORREY PINES CIR NW
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City | CANTON
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State | OH
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Zip | 44708-5984
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Country | US
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Telephone | 330-417-9991
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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 | 34007670
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License Number State | OH
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