BRADFORD L GWYTHER PA-C NPI 1356381701

NPI Information

NPI: 1356381701
Provider Name: BRADFORD L GWYTHER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: SOUTHWEST MEDICAL ASSOCIATES, LLC

PECOS Registration: Yes

Address:
502 ELM ST NE
ALBUQUERQUE, NM
ZIP 87102
Phone: (505) 841-1000
Get Directions

Bradford L Gwyther, PA-C is a medical physician assistant in Albuquerque, NM with 23 years of experience. Bradford L Gwyther, PA-C NPI is 1356381701. 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:

502 ELM ST NE
ALBUQUERQUE, NM
ZIP 87102-512
Phone: (505) 841-1000
Fax: (505) 843-2592

The NPI 1356381701 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 1/28/2016.

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
1	363A00000X	Physician Assistant		2001-PA39	NEW MEXICO	No
2	363AM0700X	Physician Assistant	Medical	2001-PA39	NEW MEXICO	Yes

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
1	P53190	MEDICARE UPIN	NEW MEXICO

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: 11/14/2023

NPI Synchronization or Removal

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