Provider Demographics
NPI:1518287176
Name:BRADFORD, RAY KARTCHNER (MD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:KARTCHNER
Last Name:BRADFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:10800 E GEDDES AVE STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3895
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197155207R00000X
NE302232085R0202X
CO590522085R0202X
HIMD194352085R0202X
FLME 1227182085R0204X
KS04-403802085R0202X
FLME122718390200000X
CODR.00590522085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO587995ZNTBOtherMEDICARE PIN
CO1518287176Medicaid
CO587995YQ3LOtherMEDICARE PIN
CO587995ZLJ3OtherMEDICARE PIN
CO587995YQ33OtherMEDICARE PIN
CO587995YQPGOtherMEDICARE PIN
NENA1214120OtherMEDICARE PIN
CO587995YQN9OtherMEDICARE PIN
NENA2517098OtherMEDICARE PIN
NENA1215121OtherMEDICARE PIN