Basic Information
| Provider Information | |||||||||
| NPI: | 1316324205 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRADLEY ANESTHESIOLOGY PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 TURNPIKE RD | ||||||||
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| City: | MT PLEASANT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156662547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244234127 | ||||||||
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| Practice Location | |||||||||
| Address1: | 401 E MURPHY AVE | ||||||||
| Address2: | |||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154252724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246281500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2015 | ||||||||
| LastUpdateDate: | 04/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | BRADLEY | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | LAWRENCE | ||||||||
| AuthorizedOfficialTitleorPosition: | ANESTHESIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 7246281500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD032797E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.