Provider Demographics
NPI:1699768978
Name:LISTER, BRADLEY A (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:A
Last Name:LISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5541 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-2650
Mailing Address - Country:US
Mailing Address - Phone:641-752-0654
Mailing Address - Fax:641-844-2206
Practice Address - Street 1:312 EAST MAIN
Practice Address - Street 2:MCFARLAND CLINIC, PC
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-0000
Practice Address - Country:US
Practice Address - Phone:641-752-0654
Practice Address - Fax:641-844-2206
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33486207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G29756Medicare UPIN