Provider Demographics
NPI:1730125220
Name:HADFORD, DAVID JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:HADFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1725
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-1725
Mailing Address - Country:US
Mailing Address - Phone:308-398-6400
Mailing Address - Fax:308-398-6408
Practice Address - Street 1:3610 RICHMOND CIR
Practice Address - Street 2:STE 100
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3910
Practice Address - Country:US
Practice Address - Phone:308-398-6400
Practice Address - Fax:308-398-6408
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE186032085R0202X
WI375332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE300117032OtherRAILROAD MEDICARE
NE34080OtherBLUE CROSS BLUE SHIELD
NE34080OtherBLUE CROSS BLUE SHIELD
NEF58017Medicare UPIN
NE273257Medicare ID - Type Unspecified