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NPI Code Detail

MEDICARE: JOHN BRADLEY ATKINS CRNA

MEDICARE: JOHN BRADLEY ATKINS CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistR853414MS
2367500000XCertified Registered Nurse Anesthetist853414MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164520425
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BRADLEY ATKINS CRNA
Provider Business Mailing Address
First Line : PO BOX 8058
Second Line :
City : COLUMBUS
State : MS
Zip : 39705-0007
Country : US
Telephone Number : 662-574-5539
Fax Number : 662-327-6004
Provider Business Practice Location Address
First Line : 2520 5TH ST N
Second Line :
City : COLUMBUS
State : MS
Zip : 39705-2008
Country : US
Telephone Number : 662-244-1000
Fax Number : 662-327-9388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/04/2025

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