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NPI Code Detail

MEDICARE: DR. TIMOTHY KRISTOFER BRADNER PHARM.D.

MEDICARE: DR. TIMOTHY KRISTOFER BRADNER PHARM.D.
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
1183500000XPharmacist03227995OH

General Provider Information

NPI Number : 1689817116
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY KRISTOFER BRADNER PHARM.D.
Provider Business Mailing Address
First Line : 1731 LOGAN AVE
Second Line :
City : FINDLAY
State : OH
Zip : 45840-1617
Country : US
Telephone Number : 248-953-6110
Fax Number :
Provider Business Practice Location Address
First Line : 5400 PERRY DR
Second Line :
City : WATERFORD
State : MI
Zip : 48329-3461
Country : US
Telephone Number : 248-674-7950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2009
Last Update Date : 04/14/2009

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