Bradford, Gary
Bradford, Gary is an sole proprietor health care provider with primary practice located at 928 N York St Suite 20, Muskogee OK 74403-3123. He recently has only one registered license in Dietary & Nutritional Service Providers / Dietary Manager, which is considered as his primary health care specialty. Bradford, Gary can be contacted via phone (918) 913-9109.Contact Information
Primary practice address
928 N York St Suite 20
Muskogee OK 74403-3123
Phone: (918) 913-9109
Fax: (918) 913-9112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietary Manager | 132700000X |
Profile Details
| NPI number | 1124327267 |
|---|---|
| LBN Legal business name | Bradford, Gary |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 15th, 2011 |
| Last updated | Oct 14th, 2011 - about 13 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 | 1124327267 | NPPES |
| Oklahoma | MEDICAID | 380025 |
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