Individual
BRADLEY KEITH DEAFENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-1813
(916) 703-5074
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-0815
(757) 953-1269
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
A130245
CA
Other
Enumeration date
06/05/2008
Last updated
07/27/2022
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