Individual provider · Type 1 NPI
Ryan Bradley, PA-C, CAQ-PSY
Medical Physician Assistant · Eglin, FL
NPI number
1235862012
Active
Practice location
4315 El Salvador Way
Eglin, FL 32542-1711
Mailing address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Other practice locations
- 6600 Van Aalst Blvd, Fort Moore, GA 31905-2102 · (915) 742-2273
- 1 11th Ave Ste A2, Shalimar, FL 32579-1318 · (850) 790-9621
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 9118992 (FL) |
| Physician Assistant | 363A00000X | 1198847 (TX) |
Medical Physician Assistant: Definition to come...
5 other providers at this address
- 96th Medgrp-EglinMilitary/U.S. Coast Guard Pharmacy Eglin Afb, FL NPI 1083012223
- John Christen Bunyasaranand, DOEmergency Medicine Physician Eglin Afb, FL NPI 1780105817
- Mary Cason ParhamDental Hygienist Eglin Afb, FL NPI 1457040867
- Ngoc Kelsch, DENTAL HYGIENISTDental Hygienist Eglin Afb, FL NPI 1558719948
- Stephanie A. Wallgren, PharmDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist Eglin Afb, FL NPI 1578859989
About NPI 1235862012
Ryan Bradley, PA-C, CAQ-PSY's National Provider Identifier is 1235862012, issued on Jul 7, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Eglin, FL. The record was last updated on Oct 4, 2024.