Provider Demographics
NPI:1992327449
Name:BECKER, BRADLEY MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:MICHAEL
Last Name:BECKER
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 1:13725 METCALF AVE # 403
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-7899
Mailing Address - Country:US
Mailing Address - Phone:913-498-8787
Mailing Address - Fax:913-498-1744
Practice Address - Street 1:7400 W 132ND STREET
Practice Address - Street 2:STE 120
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:913-498-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-48186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine