Provider Demographics
NPI:1508326232
Name:BROWN, BRADLEY (DO)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 COMPASS DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2679
Mailing Address - Country:US
Mailing Address - Phone:720-712-2271
Mailing Address - Fax:
Practice Address - Street 1:105 WELLS ST STE 100
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-5072
Practice Address - Country:US
Practice Address - Phone:425-802-9737
Practice Address - Fax:720-712-9078
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0065506208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty