Bradford, Russell D

Bradford, Russell D is an individual health care provider with primary practice located at 1034 N 500 W , Provo UT 84604-3380. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases, which is considered as his primary health care specialty. Bradford, Russell D can be contacted via phone (801) 491-6482.

Contact Information

Primary practice address
1034 N 500 W Provo UT 84604-3380
Phone: (801) 491-6482
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X 23648 Alabama

Profile Details

NPI number 1316093446
LBN Legal business name Bradford, Russell D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jun 8th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316093446 NPPES
Alabama MEDICAID 009919575
Alabama MEDICAID 009912727
Alabama MEDICAID 009919585
Alabama Other 051545309

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