Individual
MR. ROBERT LEE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
508 GORDON AVE, THOMASVILLE, GA 31792-6646
(229) 226-0125
(229) 226-0195
Mailing address
508 GORDON AVE, THOMASVILLE, GA 31792-6646
(229) 226-0125
(229) 226-0195
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002033
GA
363AM0700X
Medical Physician Assistant
PA2799
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001321A
—
GA
Enumeration date
02/28/2007
Last updated
07/09/2013
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