Individual
BRADLEY EARL DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
2409 HOMER CLAYTON DR, GUNTERSVILLE, AL 35976-2207
(256) 582-3203
(256) 582-3216
Mailing address
175 GRANT RD NE, ARMUCHEE, GA 30105-2618
(706) 673-9743
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51522613
BCBS
AL
Enumeration date
08/08/2006
Last updated
07/08/2007
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