Individual
WILLIAM R BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3 AUDUBON PLAZA DR STE 230, LOUISVILLE, KY 40217-1319
(502) 636-0574
(502) 636-0579
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21976
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64219769
—
KY
Enumeration date
08/24/2006
Last updated
01/12/2021
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