Healthcare Provider Details

I. General information

NPI: 1972061927
Provider Name (Legal Business Name): BRADLEY B ANDERSON MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 E SOUTHERN AVE STE 7
TEMPE AZ
85282-7612
US

IV. Provider business mailing address

2421 E SOUTHERN AVE STE 7
TEMPE AZ
85282-7612
US

V. Phone/Fax

Practice location:
  • Phone: 480-425-2160
  • Fax: 480-351-8797
Mailing address:
  • Phone: 480-425-2160
  • Fax: 480-351-8797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRADLEY B ANDERSON
Title or Position: ANESTHESIOLOGIST
Credential: MD
Phone: 480-425-2160