Provider Demographics
NPI:1942490321
Name:KIEFFER, BRADLEY DONALD (MD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:DONALD
Last Name:KIEFFER
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 1:1514 JOSEPH ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4258
Mailing Address - Country:US
Mailing Address - Phone:504-810-2022
Mailing Address - Fax:
Practice Address - Street 1:1514 JOSEPH ST
Practice Address - Street 2:UNIT B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-4258
Practice Address - Country:US
Practice Address - Phone:504-810-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.200645207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine