Organization
JOHN A. BRADFORD M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ADDITON BRADFORD MD (OWNER/PRESIDENT)
(207) 945-9461
Entity
Organization
Contact information
Practice address
151 BROADWAY, BANGOR, ME 04401-5207
(207) 945-9461
(207) 945-3241
Mailing address
151 BROADWAY, BANGOR, ME 04401-5207
(207) 945-9461
(207) 945-3241
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
011526
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116170000
—
ME
Enumeration date
10/27/2009
Last updated
10/27/2009
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