Individual
BRADFORD W FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9500 INDEPENDENCE DR STE 900, ANCHORAGE, AK 99507-4686
(907) 522-1341
(907) 522-1343
Mailing address
9500 INDEPENDENCE DRIVE, SUITE 900, ANCHORAGE, AK 99507
(907) 522-1341
(907) 522-1343
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01076617A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
102803
AK
207V00000X
Obstetrics & Gynecology Physician
35-086531
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639861
—
AK
05
—
2588043
—
OH
01
—
4164681
MEDICARE ID
OH
01
—
4164682
MEDICARE ID
OH
05
—
732092
—
OH
Enumeration date
04/18/2006
Last updated
03/17/2018
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