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General NPI Number Information
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NPI Number | 1801067756
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Entity Type | Organization
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Legal Business Name | WILLIAM S BRADFORD MD PA
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 05/17/2010
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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 | OWNER
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Name | DR. WILLIAM S BRADFORD
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Credential | MD
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Telephone | 336-349-4024
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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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