IndividualActive
Russell Bradford, M.D.
NPI 1316093446 · Pediatric Infectious Diseases Physician · Provo, UT
Provider details
- NPI number
- 1316093446
- Entity type
- Individual
- Primary specialty
- Pediatric Infectious Diseases PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 23648 (AL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1034 N 500 W
Provo, UT 84604-3380
Phone: (801) 491-6482
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 27128
Salt Lake City, UT 84127-0128
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2012-06-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.