Waters, Bradford

Waters, Bradford is an individual health care provider with primary practice located at 1910 Nonconnah Blvd Suite 120, Memphis TN 38132-2113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hepatology, which is considered as his primary health care specialty. Waters, Bradford can be contacted via phone (901) 448-2300.

Contact Information

Primary practice address
1910 Nonconnah Blvd Suite 120 Memphis TN 38132-2113
Fax: (901) 448-6657
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hepatology 207RI0008X 15969 Tennessee

Profile Details

NPI number 1134186083
LBN Legal business name Waters, Bradford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 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 1134186083 NPPES
Tennessee MEDICAID 3064720

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