EDWARD WILLARD BRADSHAW PA-C NPI 1235192774

NPI Information

  • NPI: 1235192774
  • Provider Name: EDWARD WILLARD BRADSHAW, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • Address: 72 LAKE HAVASU AVE S STE 102
    LAKE HAVASU CITY, AZ
    ZIP 86403
  • Phone: (928) 453-2211

Map and Directions

Get Directions

NPI Details

Edward Willard Bradshaw, PA-C is a surgical physician assistant in Lake Havasu City, AZ. Edward Willard Bradshaw, PA-C NPI is 1235192774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

72 LAKE HAVASU AVE S STE 102
LAKE HAVASU CITY, AZ
ZIP 86403-857
Phone: (928) 453-2211
Fax: (928) 453-2213

The enumeration date for this NPI number is 4/7/2006 and was last updated on 6/29/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgicalPA2576FLORIDANo
2363AS0400XPhysician AssistantSurgical5357ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1040403MEDICAIDARIZONA
2291637100MEDICAIDFLORIDA
3P00221346OTHERRAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI