Organization
JIM BRADWAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM BRADWAY MD (OWNER)
(801) 364-2278
Entity
Organization
Contact information
Practice address
630 MEDICAL DR, BOUNTIFUL, UT 84010-4908
(801) 292-6231
Mailing address
201 E SOUTH TEMPLE, 619, SALT LAKE CITY, UT 84111-1250
(801) 364-2278
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1654201205
UT
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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