Individual
WILLIAM B BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2114 N JACKSON ST, TULLAHOMA, TN 37388-2208
(931) 454-9423
(931) 454-9690
Mailing address
DEPT 0765, PO BOX 11407, BIRMINGHAM, AL 35246-0765
(256) 383-3325
(480) 212-8451
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD0000025802
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3867811
—
TN
01
—
4019082
BLUE CROSS BLUE SHIELD
TN
Enumeration date
05/27/2005
Last updated
03/03/2011
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