Individual
TAMMY M RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1906 BELLEVIEW AVE SE, EMERGENCY DEPT., ROANOKE, VA 24014-1838
(540) 981-7000
(540) 981-9550
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002144
VA
363AM0700X
Medical Physician Assistant
0110002144
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010206561
—
VA
05
—
010206596
—
VA
05
—
010206600
—
VA
Enumeration date
09/08/2006
Last updated
07/18/2023
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