Bradbury, Thomas Lane
Bradbury, Thomas Lane is an individual health care provider with primary practice located at 59 Executive Park S , Atlanta GA 30329-2208. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, which is considered as his primary health care specialty. Bradbury, Thomas Lane can be contacted via phone (404) 778-7188.Contact Information
Primary practice address
59 Executive Park S
Atlanta GA 30329-2208
Phone: (404) 778-7188
Fax: (404) 778-7036
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery | 207XS0114X | 200600296 | North Carolina |
| Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery | 207XS0114X | 059130 | Georgia |
Profile Details
| NPI number | 1720019698 |
|---|---|
| LBN Legal business name | Bradbury, Thomas Lane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Feb 1st, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720019698 | NPPES |
| North Carolina | MEDICAID | 5904146 |
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