Provider Demographics
NPI:1134581051
Name:BRADFORD, DAVIS (MD)
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:
Last Name:BRADFORD
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 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:470-220-4076
Practice Address - Street 1:530 BEACON PKWY W STE 301
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3196
Practice Address - Country:US
Practice Address - Phone:205-801-5840
Practice Address - Fax:470-220-4076
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA277661207R00000X
AL40755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine