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NPI Code Detail

MEDICARE: MS. ANN BRADLEY DR. OF AUDIOLOGY

MEDICARE: MS. ANN BRADLEY DR. OF AUDIOLOGY
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
1231H00000XAudiologistA 00907OH
2237700000XHearing Instrument SpecialistA 00907OH
3237600000XAudiologist-Hearing Aid FitterA 00907OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000221897OTHEROHANTHEM GROUP #

General Provider Information

NPI Number : 1497979579
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN BRADLEY DR. OF AUDIOLOGY
Provider Business Mailing Address
First Line : 1222 S PATTERSON BLVD
Second Line : STE 400
City : DAYTON
State : OH
Zip : 45402-2642
Country : US
Telephone Number : 937-496-2620
Fax Number : 937-424-8518
Provider Business Practice Location Address
First Line : 4710 TROY PIKE
Second Line :
City : DAYTON
State : OH
Zip : 45424-5740
Country : US
Telephone Number : 937-233-1230
Fax Number : 937-236-8930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 12/08/2017

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