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Individual

BRADFORD GIBSON TENNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
14520 W GRANITE VALLEY DR, SUITE 210, SUN CITY WEST, AZ 85375-5855
(623) 537-5600
(866) 939-2673
Mailing address
18444 N 25TH AVE, SUITE 310, PHOENIX, AZ 85023-1261
(623) 537-5600
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4952
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
650840
AZ
Enumeration date
08/11/2011
Last updated
08/11/2025
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