person
Edward Willard Bradshaw III, PA-C
Surgical Physician Assistant in Lake Havasu City, Arizona
NPI 1235192774

Edward Willard Bradshaw III is a Surgical Physician Assistant based in Lake Havasu City, AZ and is specialized in Surgical. Edward Willard Bradshaw III practices in Lake Havasu City, AZ and has the professional credentials of PA-C. The NPI Number for Edward Willard Bradshaw III is 1235192774 and holds a License No. PA2576 (Arizona).

The current practice location address for Edward Willard Bradshaw III is 72 Lake Havasu Ave S Ste 102, Lake Havasu City, AZ and can be reached out via phone at 928-453-2211 and via fax at 928-453-2213. You can also correspond with Edward Willard Bradshaw III through the mailing address at 72 LAKE HAVASU AVE S STE 102, LAKE HAVASU CITY, AZ - 86403-0857 (mailing address contact number: 928-453-2211).

Location: 72 Lake Havasu Ave S Ste 102, Lake Havasu City, AZ, 86403-0857
person
Provider Profile Details
NPI Number
1235192774
Provider Name
Edward Willard Bradshaw III
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
72 Lake Havasu Ave S Ste 102, Lake Havasu City, AZ, 86403-0857
Phone Number
928-453-2211
Fax Number
928-453-2213
Provider Enumeration Date
04/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
040403 05 AZ
291637100 05 FL
P00221346 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
72 Lake Havasu Ave S Ste 102
City
State
Zip
86403-0857
Phone Number
928-453-2211
Fax Number
928-453-2213
person
Provider Business Mailing Address Details
Address
72 Lake Havasu Ave S Ste 102
City
State
Zip
86403-0857
Phone Number
928-453-2211
Fax Number
928-453-2213
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA2576 (Florida)
Definition
Definition to come...
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