William W. Bradley, M.D., P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WILLIAM W. BRADLEY, M.D., P.C.

Practice address

120 N Rollins St
Centralia, MO 65240-1327

Phone

(573) 682-2101

Fax

(573) 682-2496

NPI assigned

Jun 22, 2010

Last updated

Jun 22, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William W Bradley, M.D.

Title

President

Phone

(573) 682-2101

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1619298809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N ROLLINS ST",
            "city": "CENTRALIA",
            "state": "MO",
            "postal_code": "652401327",
            "telephone_number": "573-682-2101",
            "fax_number": "573-682-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N ROLLINS ST",
            "city": "CENTRALIA",
            "state": "MO",
            "postal_code": "652401327",
            "telephone_number": "573-682-2101",
            "fax_number": "573-682-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM W. BRADLEY, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-682-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200178903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Centralia, MO
• Providers in Centralia, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.