Provider Demographics
NPI:1598964454
Name:SCHWARZ, BRADFORD WILLIAM (PA)
Entity Type:Individual
Prefix:
First Name:BRADFORD
Middle Name:WILLIAM
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:417 COCHRAN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2314
Mailing Address - Country:US
Mailing Address - Phone:770-231-9137
Mailing Address - Fax:
Practice Address - Street 1:CHARLES T WETHINGTON BLDG RM 205
Practice Address - Street 2:900 SOUTH LIMESTONE STREE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0200
Practice Address - Country:US
Practice Address - Phone:859-218-0514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant