Organization
BRADFORD G CARPER SR DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD G CARPER SR. DO (PRESIDENT)
(660) 747-8154
Entity
Organization
Contact information
Practice address
511 BURKARTH RD, WARRENSBURG, MO 64093-3103
(660) 747-8154
(660) 747-9757
Mailing address
511 BURKARTH RD, WARRENSBURG, MO 64093-3103
(660) 747-8154
(660) 747-9757
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R2E05
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242015618
—
MO
01
—
DN5221
RAILROAD MEDICARE
MO
01
—
MA1120
MEDICARE PTAN #
—
Enumeration date
06/18/2008
Last updated
12/03/2010
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