Provider Demographics
NPI:1982699302
Name:WILLIAMS, BRADFORD JAY (MD)
Entity type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:JAY
Last Name:WILLIAMS
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:PSC 37
Mailing Address - Street 2:BOX 597
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09459
Mailing Address - Country:GB
Mailing Address - Phone:0114-416-3854
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5210
Practice Address - Street 2:BOX 230
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461
Practice Address - Country:GB
Practice Address - Phone:0114-416-3852
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2413207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine