BRADLEY DANIEL PAGE (NPI# 1265490098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265490098 |
| Entity Type | Individual |
| Full Name | BRADLEY DANIEL PAGE |
| Credential | PA |
| Practice Address |
2005 Pioneer St Ste C Waycross GA 31501-6205 |
| Mailing Address |
11608 Central Ave Hoboken GA 31542-2106 |
| Practice Telephone | 9124907777 |
| Practice Fax Number | 9124907778 |
| Mailing Telephone | 9122883417 |
| Mailing Fax Number | 9122838204 |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 4755 | GA | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
004775 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 711 Knight Ave, Waycross, GA 315011943 | 9122839423 | 9122838204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336577014 | Bradley Page | Nurse Anesthetist, Certified Registered | 619 19th St S, Birmingham, AL 35249-1711 | 2013-10-16 |
| Street Address |
2005 PIONEER ST STE C |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-6205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649819343 | Faith Family Practice | General Practice | 2005 Pioneer St Ste C, Waycross, GA 31501-6205 | 2019-12-27 |
| 1720205503 | Diabetes and Endocrine Treatment Center Inc. | Specialist | 2005 Pioneer St Ste C, Waycross, GA 31501-6205 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912322371 | Mekedese Tesfaye | Physician Assistant | 1617 Satilla Blvd, Waycross, GA 31501-5027 | 2014-02-21 |
| 1619075884 | Ronald Eugene Jones | Physician Assistant | 615a Pendleton St, Waycross, GA 31501-4724 | 2006-09-20 |
| 1831665389 | Mikayla Brittney Freeman | Physician Assistant | 1900 Tebeau St, Emergency Department, Waycross, GA 31501 | 2018-10-22 |
| 1831456409 | Roxy J Sheffield | Physician Assistant | 711 Knight Ave, Waycross, GA 31501-1943 | 2012-04-19 |
| 1609048024 | Tia Alynn George | Physician Assistant | 1218 Alice St, Waycross, GA 31501-4525 | 2008-03-26 |
| 1275710683 | John Franklin Jacobs | Physician Assistant | 410 Darling Ave, Waycross, GA 31501-5246 | 2008-01-28 |
| 1366523292 | Jonathan S Dial | Physician Assistant | 1900 Tebeau St, Waycross, GA 31501-6357 | 2006-10-18 |
| 1891875878 | Randall W Mccarthy | Physician Assistant | 711 Knight Ave, Waycross, GA 31501-1943 | 2006-10-16 |
| 1316043227 | Amanda Mccook | Physician Assistant | 409 Uvalda St, Waycross, GA 31501-4574 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.