Individual ProviderBradley DunlavyInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831(502) 629-5552(502) 588-9490PECOS EnrollmentBased on the most recent information from CMS, provider Bradley Dunlavy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1528591492Provider TypeIndividualFull NameDunlavy, BradleyTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date4/7/2017Last Updated10/14/2020Contact InformationPractice LocationPractice Address200 E Chestnut St Bldg Suite303, Louisville, KY 40202-1831Phone(502) 629-5552Fax(502) 629-3132Mailing LocationMailing AddressPO Box 776351, Chicago, IL 60677-6351Phone(502) 588-9490Fax(502) 272-5116Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseTP376KentuckyCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer