Individual
BRADFORD L TALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2353 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 552-4823
Mailing address
2353 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 552-4823
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
47797
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091653600
—
MN
Enumeration date
02/15/2006
Last updated
10/21/2008
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