Organization Name: | HAL BRADFORD MD PA |
NPI Number: | 1265767859 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS HAL BRADFORD (OWNER) |
Mailing Address: | 3000 N Market Ave. Suite E Fayetteville |
State: | AR US |
Postal Code: | 727033507 |
Phone Number: | 4794441440 |
Fax Number: | 4794441447 |
NPI Enumeration Date: | 10/15/2009 |
NPI Last Update Date: | 03/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | C-7898 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |