Lauderdale, Bradley L

Lauderdale, Bradley L is an individual health care provider with primary practice located at 1506 S Oneida St , Appleton WI 54915-1305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as his primary health care specialty. Lauderdale, Bradley L can be contacted via phone (920) 730-6700.

Contact Information

Primary practice address
1506 S Oneida St Appleton WI 54915-1305
Phone: (920) 730-6700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 27707 Wisconsin

Profile Details

NPI number 1871587667
LBN Legal business name Lauderdale, Bradley L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Feb 23rd, 2010 - about 15 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 1871587667 NPPES
Wisconsin MEDICAID 30767000

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