Bradley Allen Locke

D.O. | Pediatric Allergy-Immunology | Male

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Complete Profile:

Bradley Allen Locke basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Allergy/Immunology
Provider Name :	Bradley Allen Locke
Credential :	D.O.
Gender :	Male

Business Address:

Bradley Allen Locke address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	2793 Lineville Rd Green Bay, WI, 54313-7152 United States
Phone Number :	920-496-4700

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1336300276
NPI Entity Type :	Individual
First Enrolment Date :	23 Jun, 2008
Last Updated On :	05 Aug, 2014

Medicare Participation:

Bradley Allen Locke participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	1951579986
Medicare Enrollment ID :	I20110719000328
Primary Specialty :	Allergy/immunology
Medical School :	Other
Graduation Year :	2008
Accepts Medicare?	Yes. Bradley Allen Locke accepts medicare insurance.

Group Practice Association:

Bradley Allen Locke is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Bradley Allen Locke is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
St Vincent Hospital-hospital Sisters-third Order Of St Francis	5799694675	553	670 Cormier Rd Green Bay, WI - 543044824 Ph: 9204949685	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bradley Allen Locke are as mentioned. Primary taxonomy code for Bradley Allen Locke, D.O. is 2080P0201X (Pediatrics Pediatric Allergy/Immunology).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	55834	WI
2080P0201X	Pediatrics Pediatric Allergy/Immunology	Yes	55834-020	WI

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	2793 Lineville Rd Green Bay, WI, 54313-7152 United States
Phone Number :	920-496-4700

Business Location:

Patients can refer following map for directions to Bradley Allen Locke practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.