Wall, Bradford
Wall, Bradford is an individual health care provider with primary practice located at 15 Medical Dr Ne , Cartersville GA 30121-8005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wall, Bradford can be contacted via phone (770) 386-5221.Contact Information
Primary practice address
15 Medical Dr Ne
Cartersville GA 30121-8005
Phone: (770) 386-5221
Fax: (770) 386-1128
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 5956 | Kansas |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 062298 | Georgia |
Profile Details
| NPI number | 1568684975 |
|---|---|
| LBN Legal business name | Wall, Bradford |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Jan 20th, 2014 - about 10 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 | 1568684975 | NPPES |
| Tennessee | MEDICAID | 3709355 |
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