Individual
JAMES RANDOLPH BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
104 HUDGINS ST, ESTILL SPRINGS, TN 37330-3027
(931) 649-5050
(931) 649-3148
Mailing address
104 HUDGINS ST, ESTILL SPRINGS, TN 37330-3027
(931) 649-5050
(931) 649-3148
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452213
—
TN
Enumeration date
06/13/2005
Last updated
02/09/2012
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