Provider Demographics
NPI:1518900562
Name:WEBB, BRAD SCOTT (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:SCOTT
Last Name:WEBB
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W ROYAL HUNTE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-8351
Mailing Address - Country:US
Mailing Address - Phone:435-586-2225
Mailing Address - Fax:435-867-1909
Practice Address - Street 1:1811 W ROYAL HUNTE DR STE 2
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-8351
Practice Address - Country:US
Practice Address - Phone:435-586-2225
Practice Address - Fax:435-867-1909
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6044606-0501213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT528552282001Medicaid
DF1798OtherPALMETTO GBA
UT528552282001Medicaid
V09419Medicare UPIN