Individual
BRADLEY MARK BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2006 BIRDIE THOMPSON DRIVE, POCATELLO, ID 83201
(208) 232-1132
(208) 232-1134
Mailing address
2006 BIRDIE THOMPSON DRIVE, POCATELLO, ID 83201
(208) 232-1132
(208) 232-1134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7466
ID
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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