Dr J Colton Bradshaw, MD11/11/1952 | |
2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2371 | |
(903) 572-9823 | |
(903) 572-4812 |
Full Name | Dr J Colton Bradshaw |
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Gender | Male |
Speciality | Pediatrics |
Location | 2001 N Jefferson Ave, Mount Pleasant, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902893019 | NPI | - | NPPES |
130955102 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | F8808 (Texas) | Primary |
Entity Name | The Pediatric Clinic, P.a.. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821085721 PECOS PAC ID: 4880747534 Enrollment ID: O20090729000146 |
Mailing Address | Practice Location Address |
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Dr J Colton Bradshaw, MD11/11/1952 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2371 Ph: (903) 572-9823 | Dr J Colton Bradshaw, MD11/11/1952 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455-2371 Ph: (903) 572-9823 |
Dr. Joel D. Chapman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455 Phone: 903-572-9823 Fax: 903-572-4812 | |
Michael Henry, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455 Phone: 903-572-9823 Fax: 903-572-4812 | |
Dr. Marc E Kimball, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455 Phone: 903-572-9823 Fax: 903-572-4812 | |
Dr. Gerald A Stagg, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2001 N Jefferson Ave, Suite 300, Mount Pleasant, TX 75455 Phone: 903-572-9823 Fax: 903-572-4812 |