Organization
BRADFORD PLACE SURGERY AND LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L WYNN (CREDENTIALING)
(417) 823-2838
Entity
Organization
Contact information
Practice address
1531 E BRADFORD PARKWAY STE 120, SPRINGFIELD, MO 65804-6539
(417) 886-3900
(417) 886-0094
Mailing address
1531 E BRADFORD PKWY STE 100, SPRINGFIELD, MO 65804-6539
(417) 886-3900
(417) 823-2894
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
118.6
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506002104
—
MO
Enumeration date
05/27/2005
Last updated
10/31/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us