Individual
BRADLEY J MAGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
135B MIDWAY DR, DU BOIS, PA 15801
(814) 371-2348
(814) 372-6090
Mailing address
135B MIDWAY DR, DU BOIS, PA 15801-3857
(814) 371-2348
(814) 372-6090
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003260L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090188
UNISON THREE RIVERS MEDPL
PA
05
—
0011362640005
—
PA
01
—
1035572
GATEWAY PA MEDICAID
PA
01
—
201856
UPMC
PA
01
—
364643
HIGHMARK BC BS PA
PA
Enumeration date
07/28/2006
Last updated
01/30/2019
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