Provider Demographics
NPI:1164880225
Name:DOERING, BRADLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:DOERING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 BERBERICH DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3275
Mailing Address - Country:US
Mailing Address - Phone:859-372-3490
Mailing Address - Fax:
Practice Address - Street 1:9950 BERBERICH DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3275
Practice Address - Country:US
Practice Address - Phone:859-372-3490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016464183500000X, 1835P0018X
OH032329091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist