NPI 1376882563 · live from the CMS NPI Registry
Jerry Allen Bradley, MD, EdD, MDiv
Family Medicine, Geriatric Medicine in Mobile, AL. National Provider Identifier 1376882563, active.
NPI record
| NPI | 1376882563 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine, Geriatric Medicine 207QG0300X |
| Practice location | 575 Stanton Rd, Mobile, AL 36617 |
| Practice phone | 251-471-7207 |
| Mailing address | Po Box 746450, Atlanta, GA 30374 |
| Enumerated | February 7, 2013 |
| Last updated | June 16, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine, Hospice and Palliative Medicine | 207QH0002X | MD.34716 (AL) |
| Family Medicine, Geriatric Medicine primary | 207QG0300X | MD.34716 (AL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.