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Individual

MR. SPENCER A BRADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-S2

Contact information

Practice address
620 W LEXINGTON ST, BALTIMORE, MD 21201-1508
(970) 978-7005
Mailing address
201 LAMKIN ST, APT 101, PUEBLO, CO 81003-3558
(719) 543-6633
(719) 543-6655

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant
PA.0006388
CO

Other

Enumeration date
10/14/2019
Last updated
10/22/2025
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