Organization
CHARLES R BRADFORD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R BRADFORD M.D. (PRESIDENT)
(256) 259-6054
Entity
Organization
Contact information
Practice address
508 HARLEY ST STE D, SCOTTSBORO, AL 35768-4263
(256) 259-6054
(256) 259-5206
Mailing address
508 HARLEY ST STE D, SCOTTSBORO, AL 35768-4263
(256) 259-6054
(256) 259-5206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00007481
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51003793
BLUE CROSS OF AL
AL
Enumeration date
11/28/2006
Last updated
08/22/2020
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