Black, Bradford Thomas

Black, Bradford Thomas is an individual health care provider with primary practice located at 885 S Sawburg Rd Suite 105, Alliance OH 44601-5905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Black, Bradford Thomas can be contacted via phone (330) 823-1112.

Contact Information

Primary practice address
885 S Sawburg Rd Suite 105 Alliance OH 44601-5905
Phone: (330) 823-1112
Fax: (330) 823-1139
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 58282 Ohio

Profile Details

NPI number 1356326136
LBN Legal business name Black, Bradford Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated May 12th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356326136 NPPES
Ohio MEDICAID 0738536
Ohio Other 340012867

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