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General NPI Number Information
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NPI Number | 1033152343
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Entity Type | Individual
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Provider Name | WILLIAM S BRADFORD MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 617 S MAIN ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5019
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Country | US
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Telephone | 336-349-4024
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Fax | 336-349-6904
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | REIDSVILLE
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State | NC
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Zip | 27323-0150
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Country | US
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Telephone | 336-349-4024
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Fax | 336-349-6904
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 29079
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License Number State | NC
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