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General NPI Number Information
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NPI Number | 1164462602
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Entity Type | Individual
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Provider Name | BRADFORD P GARNER MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 550 S HUDSON AVE
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City | AURORA
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State | MO
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Zip | 65605-2362
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Country | US
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Telephone | 417-678-5176
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Fax | 417-678-0675
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Provider Business Mailing Address
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Address Line | PO BOX 2580
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City | SPRINGFIELD
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State | MO
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Zip | 65801-2580
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Country | US
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Telephone | 417-820-0289
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Fax | 417-820-0437
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 6533
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2009001435
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License Number State | MO
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