Individual
WILLIAM DANIEL BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2960 E. ST. LUKES ST., STE. 200, MERIDIAN, ID 83642-6011
(208) 992-5212
(208) 992-5452
Mailing address
2960 E. ST. LUKES ST., STE. 200, MERIDIAN, ID 83642-6011
(208) 992-5212
(208) 992-5452
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
L0043
TX
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M-13237
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0405045-01
—
TX
Enumeration date
06/14/2006
Last updated
05/22/2024
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