Provider Demographics
NPI:1891778403
Name:CLARKE, BRADLEY JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:JOSEPH
Last Name:CLARKE
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 1:2942 TORREY PINES CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-5984
Mailing Address - Country:US
Mailing Address - Phone:330-417-9991
Mailing Address - Fax:
Practice Address - Street 1:4040 EMBASSY PKWY STE 370
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-8372
Practice Address - Country:US
Practice Address - Phone:234-466-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007670207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine