MEDICARE: BRADLEY JON JACOBSON HID

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	237700000X	Hearing Instrument Specialist	3008	MN

General Provider Information

NPI Number	:	1811822851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY JON JACOBSON HID

Provider Business Mailing Address
First Line	:	5565 BLAINE AVE STE 225
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-1239
Country	:	US
Telephone Number	:	651-888-7800
Fax Number	:	651-888-7801

Provider Business Practice Location Address
First Line	:	5565 BLAINE AVE STE 225
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-1239
Country	:	US
Telephone Number	:	651-888-7800
Fax Number	:	651-888-7801

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

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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