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Individual
DR. BRADFORD J PIZZA
Active
Individual
DR. BRADFORD J PIZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004549922
AETNA
GA
05
—
00300704A
—
GA
01
—
158550800
DEPARTMENT OF LABOR
GA
01
—
350051350
RAILROAD MEDICARE
GA
01
—
935698
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/15/2006
Last updated
09/26/2012
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