Individual provider · Type 1 NPI
Bradley Lloyd Fricke, MD
Vascular & Interventional Radiology Physician · Conyers, GA
NPI number
1174701262
Active
Practice location
1412 Milstead Ave NE
Conyers, GA 30012-3877
Fax (770) 607-0789
Mailing address
PO Box 200096
Cartersville, GA 30120-9002
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 067879 (GA) |
| Vascular & Interventional Radiology Physician Primary | 2085R0204X | 067879 (GA) |
| Diagnostic Radiology Physician | 2085R0202X | C6160 (KY) |
| Diagnostic Radiology Physician | 2085R0202X | 0101290003 (VA) |
Vascular & Interventional Radiology Physician: A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
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About NPI 1174701262
Bradley Lloyd Fricke, MD's National Provider Identifier is 1174701262, issued on Jan 31, 2008. The primary taxonomy on file is Vascular & Interventional Radiology Physician (2085R0204X), and the practice location is in Conyers, GA. The record was last updated on Oct 9, 2026.