Individual
BRADFORD P GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S HUDSON AVE, AURORA, MO 65605-2362
(417) 678-5176
(417) 678-0675
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 820-0289
(417) 820-0437
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009001435
MO
207Q00000X
Family Medicine Physician
6533
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105594
BLUE CROSS BLUE SHIELD
KS
05
—
1164462602
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00748476
RAILROAD MEDICARE
—
Enumeration date
06/06/2006
Last updated
01/19/2010
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