Individual
BRADLEY BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1904 S SHADY HILL LN, SPRINGFIELD, MO 65809-2601
(417) 860-9044
Mailing address
1904 S SHADY HILL LN, SPRINGFIELD, MO 65809-2601
(417) 860-9044
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R5G73
MO
Other
Enumeration date
04/27/2009
Last updated
04/27/2009
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