Provider Demographics
NPI:1306162151
Name:SMITH, BRADLEY HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:HOWARD
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:340 HULSA RD
Mailing Address - Street 2:NAVAL AEROSPACE MEDICAL INSTITUTE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32508-1092
Mailing Address - Country:US
Mailing Address - Phone:850-452-4657
Mailing Address - Fax:850-452-2679
Practice Address - Street 1:340 HULSA RD
Practice Address - Street 2:NAVAL AEROSPACE MEDICAL INSTITUTE
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-1092
Practice Address - Country:US
Practice Address - Phone:850-452-4657
Practice Address - Fax:850-452-2679
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAA650572083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine