Provider Demographics
NPI:1619763216
Name:PARKER, BRADLEY EDWARD (DO)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:EDWARD
Last Name:PARKER
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 1:20375 W 151ST ST
Mailing Address - Street 2:DOCTORS BUILDING 1; SUITE 325,
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061
Mailing Address - Country:US
Mailing Address - Phone:913-588-0347
Mailing Address - Fax:
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:DOCTORS BUILDING 1; SUITE 325,
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-588-0347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program