Individual
BRADON CLARK BURNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
25 N 100 E STE 102, SAINT GEORGE, UT 84770-7369
(435) 879-5101
Mailing address
345 N 2450 E UNIT 210, SAINT GEORGE, UT 84790-5754
(801) 349-9897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12351455-1206
UT
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
04/08/2021
Last updated
12/28/2021
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