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Individual
BRADFORD R EGLY
Active
Individual
BRADFORD R EGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004698
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004698
—
IL
01
—
051005617
BCBS AL
AL
01
—
051005618
BCBS AL
AL
01
—
051005619
BCBS AL
AL
01
—
051538406
BCBS AL
AL
01
—
051548831
BCBS AL
AL
01
—
059202011
BCBS AL
AL
01
—
65410
BCBS FLORIDA
FL
01
—
P00463492
RAILROAD MEDICARE
AL
Enumeration date
08/22/2006
Last updated
04/21/2010
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