Healthcare Provider Details

I. General information

NPI: 1306826086
Provider Name (Legal Business Name): BRADFORD C GELZAYD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 E BELL RD STE 3200
PHOENIX AZ
85032-2162
US

IV. Provider business mailing address

3815 E BELL RD STE 4500
PHOENIX AZ
85032-2171
US

V. Phone/Fax

Practice location:
  • Phone: 480-840-1754
  • Fax: 480-840-1764
Mailing address:
  • Phone: 602-633-3848
  • Fax: 602-633-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301051873
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: