Individual provider · Type 1 NPI
Edward Willard Bradshaw Iii, PA-C
Surgical Physician Assistant · Lake Havasu City, AZ
NPI number
1235192774
Active
Practice location
72 Lake Havasu Ave S Ste 102
Lake Havasu City, AZ 86403-0857
Fax (928) 453-2213
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA2576 (FL) |
| Surgical Physician Assistant Primary | 363AS0400X | 5357 (AZ) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
Other surgical physician assistant providers in Lake Havasu City
About NPI 1235192774
Edward Willard Bradshaw Iii, PA-C's National Provider Identifier is 1235192774, issued on Apr 7, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Lake Havasu City, AZ. The record was last updated on Jun 29, 2020.