# BRADFORD FOOT AND ANKLE SPECIALTIES

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

## Provider details

- **NPI number:** 1730196601
- **Authorized official:** DR. TIMOTHY M KUMP DPM (OWNER)
- **Authorized official phone:** (570) 265-7700

## Contact information

- **Practice address:** 1786 GOLDEN MILE RD, SUITE 1, TOWANDA, PA 18848-9733
- **Practice address phone:** (570) 265-7700
- **Practice address fax:** (570) 268-4266
- **Mailing address:** PO BOX 376, WYSOX, PA 18854-0376
- **Mailing address phone:** (570) 265-7700
- **Mailing address fax:** (570) 268-4266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC003249L | PA | Yes |

## Other

- **Enumeration date:** 08/02/2006
- **Last updated:** 04/17/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1025528480001 | — | PA |
| 01 | — | 206545 | MEDICARE PTAN | — |