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Organization

BRADFORD A STEPHENS MD PC

Active
Other names
High Peaks Sports Medicine Center
Organization subpart
No

Provider details

NPI number
Authorized official
BRADFORD A STEPHENS M.D. (PRESIDENT)
(541) 426-3463
Entity
Organization

Contact information

Practice address
601 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-3463
Mailing address
PO BOX 705, JOSEPH, OR 97846-0705
(541) 432-2032

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD09433
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194723734
NPI
NY
Enumeration date
08/17/2007
Last updated
08/17/2007
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