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General NPI Number Information
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NPI Number | 1275487696
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Entity Type | Organization
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Legal Business Name | BRADFORD PROFESSIONAL SERVICES - MS, LLC
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 226 LOWE LN
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City | LUCEDALE
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State | MS
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Zip | 39452-4313
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Country | US
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Telephone | 601-791-5135
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PERIMETER PARK S STE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35243-2327
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Country | US
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Telephone | 205-251-7753
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Fax | 205-251-7760
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Authorized Official
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Title or Position | CFO
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Name | MARK EDWARDS
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Credential |
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Telephone | 205-244-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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