Gardner, Bradley P

Gardner, Bradley P is an individual health care provider with primary practice located at 2025 E 17Th St , Idaho Falls ID 83404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Gardner, Bradley P can be contacted via phone (208) 524-2025.

Contact Information

Primary practice address
2025 E 17Th St Idaho Falls ID 83404
Phone: (208) 524-2025
Fax: (208) 529-1924
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X M6282 Idaho

Profile Details

NPI number 1255408217
LBN Legal business name Gardner, Bradley P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Jul 8th, 2007 - about 17 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 1255408217 NPPES
Idaho Other 000010000074 BLUE SHIELD
Idaho Other 000010000078 BLUE SHIELD
Idaho Other 312742 BLUE SHIELD
Idaho Other 5925A BLUE SHIELD
Idaho Other DD552 BLUE SHIELD
Idaho Other DW227 BLUE SHIELD
Idaho Other J4241 BLUE SHIELD
Idaho Other J6428 BLUE SHIELD
Idaho Other 000010000077 BLUE SHIELD

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