Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 14833 | OK |
NPI | 1013998681 |
---|---|
Provider Name | Cynthia A Bradford |
First Address | Oklahoma City, OK 73104-5014 |
Second Address | Oklahoma City, OK 73104-5014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 04/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100629650C | (05) | OK |
C94711 | (02) |