Individual
JUDITH LYNN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 ADAMS ST, LAUREL, MS 39440-4365
(601) 426-9454
(601) 426-9476
Mailing address
PO BOX 407, LAUREL, MS 39441-0407
(601) 426-9454
(601) 426-9476
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
11338
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015203
—
MS
Enumeration date
08/20/2006
Last updated
07/08/2007
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