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General NPI Number Information
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NPI Number | 1891008603
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Entity Type | Individual
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Provider Name | ASHLEY BRADFORD O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 12/19/2018
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Provider Practice Location Address
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Address Line | 4615 HIGHWAY 80 SUITE #7
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City | HAUGHTON
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State | LA
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Zip | 71037-7441
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Country | US
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Telephone | 318-949-6085
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Fax | 318-949-6084
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Provider Business Mailing Address
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Address Line | 4010 HIGHWAY 80
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City | HAUGHTON
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State | LA
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Zip | 71037-7441
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Country | US
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Telephone | 318-949-6085
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Fax | 318-949-6084
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 1586-619T
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1586-619T
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License Number State | LA
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