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Individual

BRADLEY T SUMRALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 1ST ST STE 410, MACON, GA 31201-8306
(478) 743-7068
(478) 741-1354
Mailing address
800 1ST ST STE 410, MACON, GA 31201-8306
(478) 743-7068
(478) 741-1354

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
069720
GA
207RX0202X
Medical Oncology Physician
Primary
69720
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003133948A
GA
05
003133948B
GA
05
003133948F
GA
05
003133948G
GA
05
003133948H
GA
Enumeration date
08/23/2006
Last updated
09/02/2025
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