Provider Demographics
NPI:1134693765
Name:NOLAND, BRADLEY MICHAEL (PA)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:MICHAEL
Last Name:NOLAND
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1751 VETERANS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4930
Mailing Address - Country:US
Mailing Address - Phone:256-718-3200
Mailing Address - Fax:256-246-3297
Practice Address - Street 1:1751 VETERANS DR STE 300
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4930
Practice Address - Country:US
Practice Address - Phone:256-718-3200
Practice Address - Fax:256-246-3297
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2024-08-20
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Provider Licenses
StateLicense IDTaxonomies
ALPA.1487363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant