Whitaker, Bradley

Whitaker, Bradley is an individual health care provider with primary practice located at 2163 W Orange Grove Rd , Tucson AZ 85741-3118. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Whitaker, Bradley can be contacted via phone (520) 575-0800.

Contact Information

Primary practice address
2163 W Orange Grove Rd Tucson AZ 85741-3118
Fax: (520) 575-0093
Website:

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0446 Arizona

Profile Details

NPI number 1821089624
LBN Legal business name Whitaker, Bradley
Credentials DPM., FACFAS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Dec 10th, 2012 - about 12 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 1821089624 NPPES
Arizona MEDICAID 337627
Arizona Other 5507194
Arizona Other 6287561009
Arizona Other 1Z3482
Arizona Other 480030868
Arizona Other AZ0191940

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