| Doctor Name: | MR. MICHAEL DOUGLAS BRADLEY |
| NPI Number: | 1972771293 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ADVANCED EMT |
| License Number: | 8834260 |
| Business Practice Address: | Bld 301 Andrews Ave Lyster Army Health Clinic Ft. Rucker, AL - 36362 |
| Business Phone Number: | 3342557799 |
| Business Fax Number: | |
| Mailing Address: | Bld 301 Andrews Ave, Lyster Army Health Clinic FT. RUCKER |
| State: | AL |
| Postal Code: | 36362 |
| Phone Number: | 3342557799 |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2008 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146M00000X |
| License Number: | 8834260 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Intermediate |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |