Provider Demographics
NPI:1316901010
Name:ZINK, BRADLEY LEONARD (DO)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:LEONARD
Last Name:ZINK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:408 N 4TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-1646
Mailing Address - Country:US
Mailing Address - Phone:816-230-8777
Mailing Address - Fax:816-230-8855
Practice Address - Street 1:408 N 4TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-1646
Practice Address - Country:US
Practice Address - Phone:816-230-8777
Practice Address - Fax:816-230-8855
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MODOR9F95207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO12844049OtherBC/BS KC IND PROV
MO080185566OtherRAILROAD MEDICARE
MO12844049OtherBC/BS KC IND PROV