Frost, Bradley L

Frost, Bradley L is an individual health care provider with primary practice located at 104 Fairview Park Dr , Dublin GA 31021. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Frost, Bradley L can be contacted via phone (478) 272-1366.

Contact Information

Primary practice address
104 Fairview Park Dr Dublin GA 31021
Phone: (478) 272-1366
Fax: (478) 275-2322
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 052723 Georgia

Profile Details

NPI number 1649258047
LBN Legal business name Frost, Bradley L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Dec 7th, 2009 - 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 1649258047 NPPES
Georgia MEDICAID 278071734A
Georgia Other 2501178
Georgia Other 7938678
Georgia Other 5590639
Georgia Other 52168676-001

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