MEDICARE: FALLON BRADFORD

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	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1912850595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALLON BRADFORD

Provider Business Mailing Address
First Line	:	4120 BROOKDALE LN UNIT 1
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-3998
Country	:	US
Telephone Number	:	937-901-1439
Fax Number	:

Provider Business Practice Location Address
First Line	:	4120 BROOKDALE LN UNIT 1
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-3998
Country	:	US
Telephone Number	:	937-901-1439
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

Similar Medicare Providers

1841097276 — JONNA FALKNER
Practice Location Address:

5963 KENTSHIRE DR STE A
DAYTON, OH
45440-4253

Practice Phone: 937-952-6379
Practice Fax:

1184577660 — BEAVERCREEK OH - KYLE JACKSON DDS INC
Practice Location Address:

4090 INDIAN RIPPLE RD STE 102
DAYTON, OH
45440-3292

Practice Phone: 937-986-1886
Practice Fax:

1184577595 — SAMANTHA WILBURN CSFA
Practice Location Address:

3997 SAN MARINO ST
DAYTON, OH
45440-1313

Practice Phone: 740-222-4798
Practice Fax:

1396270187 — MS. KERRI K LEWIS
Practice Location Address:

130 SHELFORD WAY
DAYTON, OH
45440-3658

Practice Phone: 401-864-0032
Practice Fax:

1316669906 — MRS. LORA BALLENGEE PA
Practice Location Address:

75 SYLVANIA DR
DAYTON, OH
45440-3237

Practice Phone: 937-320-5050
Practice Fax: 937-320-5060

1114160926 — KALYAN MOHAN BHOOPAL M.D.
Practice Location Address:

75 SYLVANIA DR
DAYTON, OH
45440-3237

Practice Phone: 937-320-5050
Practice Fax:

Directions to “ FALLON BRADFORD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.