Individual
DR. HENRY LANE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1020 TUSCALOOSA AVE, GADSDEN, AL 35901-3005
(256) 492-0131
Mailing address
PO BOX 97, GADSDEN, AL 35902-0097
(256) 492-0131
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
312
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164267
—
AL
05
—
169734
—
AL
01
—
511-55075
BCBS
AL
01
—
511-57484
BCBS
AL
Enumeration date
08/11/2005
Last updated
01/10/2020
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