Individual
DR. BRADLEY WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM., FACFAS
Contact information
Practice address
2163 W ORANGE GROVE RD, TUCSON, AZ 85741-3118
(520) 575-0800
(520) 575-0093
Mailing address
2163 W ORANGE GROVE RD, TUCSON, AZ 85741-3118
(520) 575-0800
(520) 575-0093
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0446
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z3482
HEALTH NET
AZ
05
—
337627
—
AZ
01
—
480030868
RAILROAD MEDICARE
AZ
01
—
5507194
AETNA
AZ
01
—
6287561009
CIGNA
AZ
01
—
AZ0191940
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
10/31/2005
Last updated
12/10/2012
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