Provider Demographics
NPI:1063441459
Name:BARTH, BRADLEY EUGENE (MD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:EUGENE
Last Name:BARTH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4000 CAMBRIDGE STREET
Mailing Address - Street 2:DEPT. OF EMERGENCY MEDICINE, MAILSTOP 1019
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6504
Mailing Address - Fax:913-588-9104
Practice Address - Street 1:4000 CAMBRIDGE STREET
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE, MAILSTOP 1019
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6504
Practice Address - Fax:913-588-9104
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2022-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2002005826207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100449920AMedicaid
KS100449920HMedicaid
MO205849706Medicaid
31133012OtherBCBS
KS100449920FMedicaid
KS100449920GMedicaid
930119238OtherRAILROAD MEDICARE