# JIM BRADWAY MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639475171
- **Authorized official:** DR. JIM BRADWAY MD (OWNER)
- **Authorized official phone:** (801) 364-2278

## Contact information

- **Practice address:** 630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
- **Practice address phone:** (801) 292-6231
- **Mailing address:** 201 E SOUTH TEMPLE, 619, SALT LAKE CITY, UT 84111-1250
- **Mailing address phone:** (801) 364-2278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 1654201205 | UT | Yes |

## Other

- **Enumeration date:** 02/01/2011
- **Last updated:** 02/01/2011