Organization
JOHN J. PERSHING VAMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADFORD JOSEPH DAVIS FNP (FAMILY NURSE PRACTITIONER)
(573) 776-0905
Entity
Organization
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4190
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4190
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
2015006783
MO
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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