MEDICARE: ALEC L BRADLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	35.155863	OH
2	207W00000X	Ophthalmology Physician	R6382	KY

General Provider Information

NPI Number	:	1215558218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEC L BRADLEY MD

Provider Business Mailing Address
First Line	:	500 S PRESTON ST RM 305
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-1605
Country	:	US
Telephone Number	:	513-868-2181
Fax Number	:	513-868-2893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2020
Last Update Date	:	05/12/2026

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