Individual
BRADLEY DANIEL PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2005 PIONEER ST STE C, WAYCROSS, GA 31501-6205
(912) 490-7777
(912) 490-7778
Mailing address
11608 CENTRAL AVE, HOBOKEN, GA 31542-2106
(912) 288-3417
(912) 283-8204
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4755
GA
363AM0700X
Medical Physician Assistant
Primary
004775
GA
Other
Enumeration date
05/02/2006
Last updated
02/07/2020
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