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NPI Code Detail

MEDICARE: DR. WILLIAM BRADLEY POSS MD

MEDICARE: DR. WILLIAM BRADLEY POSS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0203XPediatric Critical Care Medicine Physician1105210220UT

General Provider Information

NPI Number : 1588634729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM BRADLEY POSS MD
Provider Business Mailing Address
First Line : PO BOX 581289
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84158-1289
Country : US
Telephone Number : 801-587-7572
Fax Number : 801-581-8686
Provider Business Practice Location Address
First Line : 295 E CHIPETA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1287
Country : US
Telephone Number : 801-587-7575
Fax Number : 801-581-8686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 09/25/2015

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