Individual
BRADLEY L FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
104 FAIRVIEW PARK DR, DUBLIN, GA 31021
(478) 272-1366
(478) 275-2322
Mailing address
PO BOX 1528, DUBLIN, GA 31040-1528
(478) 272-1366
(478) 275-2322
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
052723
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2501178
UNITED HEALTHCARE
GA
05
—
278071734A
—
GA
01
—
52168676-001
BCBS
GA
01
—
5590639
FIRST HEALTH
GA
01
—
7938678
AETNA
GA
Enumeration date
01/05/2006
Last updated
12/07/2009
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