John Mark Bradford, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

T-010483 Issued in MS

Practice address

7420 Guthrie Dr N Ste 110
Southaven, MS 38671-5877

Phone

(662) 536-0384

Fax

(877) 536-4207

NPI assigned

Mar 23, 2012

Last updated

Mar 23, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1811263841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 GUTHRIE DR N STE 110",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715877",
            "telephone_number": "662-536-0384",
            "fax_number": "877-536-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 GUTHRIE DR N STE 110",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715877",
            "telephone_number": "662-536-0384",
            "fax_number": "877-536-4207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "T-010483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samuel Breite

• Pharmacist in Southaven, MS
• Providers in Southaven, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.