Individual
MR. BRADLEY GERALD HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14973 W BELL RD STE 100, SURPRISE, AZ 85374-3878
(623) 815-2900
(623) 583-1319
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3037
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85516
MEDICARE PIN #
AZ
Enumeration date
06/23/2006
Last updated
11/19/2024
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