NPI 1003351818

Bradford Emergency Group LLC

Organisation Emergency Medicine Physician Starke, FL

Practice location

Address: 922 E Call St, Starke, FL 32091-3616
Phone: (904) 368-2300
Fax: (304) 368-2306
Mailing address: 200 Corporate Blvd, Lafayette, LA 70508-3870

Authorised official

Name: Lisha Falk
Title: Vp of Contracting
Phone: (337) 354-1221

Registered specialties (3)

Emergency Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207P00000X

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

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Registry record

NPI: 1003351818
Entity type: Organization
NPI issued: 3 Jan 2017
Record last updated: 3 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.