Provider Demographics
NPI:1639194749
Name:MORSE, BRADLEY J (MD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:J
Last Name:MORSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2702 NAVARRE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3223
Mailing Address - Country:US
Mailing Address - Phone:419-696-7000
Mailing Address - Fax:419-696-7015
Practice Address - Street 1:2702 NAVARRE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3223
Practice Address - Country:US
Practice Address - Phone:419-696-7000
Practice Address - Fax:419-696-7015
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35062356M207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0983128Medicaid
OH200044048OtherRAILROAD MEDICARE
OH200044048OtherRAILROAD MEDICARE
OHF76141Medicare UPIN