Bradley Alan Stovall
Physical Medicine & Rehabilitation Doctor
11958 W Broad St
Henrico
, Virginia 23233-1007
Bradley Alan Stovall
Physical Medicine & Rehabilitation Doctor
11958 W Broad St
Henrico
, Virginia 23233-1007
(804) 560-9029
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
Languages spoken
- English
Location
First Address
- Bradley Alan Stovall
- 1115 Boulders Pkwy Ste 200
- North Chesterfield, VA
- Zip : 23225-4067
- Fax : (804) 560-9029
- Phone : (804) 915-4607
Second Address
- Bradley Alan Stovall
- 11958 W Broad St
- Henrico, VA
- Zip : 23233-1007
- Fax : (804) 364-6521
- Phone : (804) 360-4669
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0102204430 | VA |
National Provider Identifier
| NPI | 1053607945 |
|---|---|
| Provider Name | Bradley Alan Stovall |
| First Address | North Chesterfield, VA 23225-4067 |
| Second Address | Henrico, VA 23233-1007 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/06/2011 |
| Last Update Date | 09/07/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 559509 | TEXAS MEDICAL BOARD (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.