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General NPI Number Information
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NPI Number | 1265693766
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Entity Type | Organization
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Legal Business Name | BRADFORD G CARPER SR DO PC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 511 BURKARTH RD
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City | WARRENSBURG
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State | MO
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Zip | 64093-3103
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Country | US
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Telephone | 660-747-8154
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Fax | 660-747-9757
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Provider Business Mailing Address
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Address Line | 511 BURKARTH RD
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City | WARRENSBURG
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State | MO
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Zip | 64093-3103
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Country | US
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Telephone | 660-747-8154
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Fax | 660-747-9757
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRADFORD G CARPER SR.
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Credential | DO
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Telephone | 660-747-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R2E05
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License Number State | MO
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