MR. BRADLEY MARTIN (NPI# 1841249489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841249489 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY MARTIN |
| Credential | PA-C |
| Practice Address |
1014 Biglane Drive Brookhaven MS 39601 |
| Mailing Address |
1014 Big Lane Dr Brookhaven MS 39601-2331 |
| Practice Telephone | 6018235276 |
| Practice Fax Number | 6018232206 |
| Mailing Telephone | 6018235276 |
| Mailing Fax Number | 6018232206 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2017-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA00053 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06974850 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536737 | Bradley Martin | Nurse Practitioner | 31 M St Apt 110, Salt Lake City, UT 84103-3846 | 2020-07-29 |
| 1467006916 | Bradley Martin | Student in an Organized Health Care Education/Training Program | 5189 Pine Abbey Drive South, West Palm Beach, FL 33415 | 2019-08-01 |
| 1124398631 | Bradley A Martin | Speech-Language Pathologist | 509 Hummingbird Cv, Jonesboro, AR 72404-8516 | 2012-01-01 |
| 1851693659 | Bradley Eugene Martin | Contractor | 8414 Meadow Green Way, Gaithersburg, MD 20877-3741 | 2010-11-30 |
| 1689274664 | Bradley Martin | Dental Hygienist | 2630 Central Ave, Eielson Afb, AK 99702-2301 | 2020-10-28 |
| 1639788086 | Bradley Martin | Counselor | 11027 Burbank Blvd, North Hollywood, CA 91601-2431 | 2020-07-30 |
| 1144729153 | Bradley Neal Martin | Social Worker | 3809 Rosewood Dr, Columbia, SC 29205-3533 | 2018-02-05 |
| 1518481522 | Bradley Martin | Physical Therapist | 5535 S Williamson Blvd Ste 774, Port Orange, FL 32128-8321 | 2017-08-01 |
| 1376078212 | Bradley Nelson Martin | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2017-04-28 |
| 1992163638 | Bradley Martin | Counselor | 1 Veterans Dr, Minneapolis, MN 55417-2309 | 2016-02-09 |
| Street Address |
1014 BIGLANE DRIVE |
| City | BROOKHAVEN |
| State | MS |
| Zip Code | 39601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329633 | Mary Lindsey Lumley | Nurse Practitioner | 620 Hwy 51, Brookhaven, MS 39601 | 2020-09-01 |
| 1306371687 | Rocky Mountain Holdings, LLC | Ambulance | 411 Highway 51 N, Brookhaven, MS 39601 | 2017-04-25 |
| 1043759269 | Candace C Turner | Counselor | 860 E River Pl Suite 100, Jackson, MS 39601 | 2017-02-21 |
| 1619419694 | Therapy Nook PC | Speech-Language Pathologist | 520 Schwem Avenue, Brookhaven, MS 39601 | 2016-11-08 |
| 1851742639 | Melanie Smith | Specialist/Technologist | 325 Low Water Lane, Brookhaven, MS 39601 | 2016-06-23 |
| 1134597107 | Passionate Care Home Health,llc | Home Health | 537 St Charles Places, Brookhaven, MS 39601 | 2015-09-09 |
| 1205218690 | Nurse Practitioner Professionals, Pllc | Clinic/Center | 427 Highway 51 Se, Kings Daughters Medical Center-wound Healing Center, Brookhaven, MS 39601 | 2015-06-23 |
| 1043639289 | Joseph S Moak Jr Md Pa | Internal Medicine | 1040 Biglane Drive, Brookhaven, MS 39601 | 2014-04-15 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1386930113 | Hospice Advantage, LLC. | Hospice Care, Community Based | 120 W Cherokee St, Brookhaven, MS 39601 | 2011-06-20 |
| Find all providers in zip 39601 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1114392172 | Robin Rae Hoffeld | Physician Assistant | 11401 Wedgewood Ln, Ocean Springs, MS 39564-7910 | 2015-12-02 |
| 1487027504 | Advanced Surgical Assistants LLC | Physician Assistant | 1924 30th Ave Ste A, Gulfport, MS 39501-4534 | 2015-11-11 |
| 1063889509 | Julie Dianne Sullivan | Physician Assistant | 216 Linda Dr, Ocean Springs, MS 39564-4114 | 2015-09-01 |
| 1326478744 | William Bishop | Physician Assistant | 11476 Savannah Pl, Gulfport, MS 39503-1109 | 2013-11-21 |
| 1376840173 | Christopher Lawrence Sweebe | Physician Assistant | 741 Beaus Landing Dr, Gulfport, MS 39507-4347 | 2011-02-15 |
| 1528275633 | Tina M Mcginty | Physician Assistant | 250 Church Ave, Gulfport, MS 39507-1255 | 2007-05-17 |
| 1922190271 | Robert L. Gillum Jr. | Physician Assistant | 6099 Adaughtery Rd, Suite A, Long Beach, MS 39560 | 2006-09-28 |
| 1144293655 | David Bradley Robbins | Physician Assistant | 206 Oxford Rd, New Albany, MS 38652-3115 | 2006-02-07 |
| 1801877022 | Benjamin P Watts | Physician Assistant | 3615 Hospital St, Pascagoula, MS 39581-4112 | 2005-11-07 |
| Find all providers with the same taxonomy | ||||
| City | BROOKHAVEN |
| Zip Code | 39601 |
Please comment or provide details below to improve the information on MR. BRADLEY MARTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.