Dr BRADLEY DEE MANGUM is a male medical professional, specializing in Nurse Practitioner. He graduated in 2011.
NORTH CANYON MEDICAL CENTER INC
718 HWY 30
BUHL
ID
833165039
Tel: 20893444331606
| Npi | 1235465147 |
| Pac Id | 5092845883 |
| Professional Enrollment Id | I20150925001155 |
| Last Name | MANGUM |
| First Name | BRADLEY |
| Middle Name | DEE |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
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| Organization Legal Name | NORTH CANYON MEDICAL CENTER INC |
| Group Practice Pac Id | 0941371439 |
| Number Of Group Practice Members | 29 |
| Line 1 Street Address | 718 HWY 30 |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | BUHL |
| State | ID |
| Zip Code | 833165039 |
| Phone Number | 20893444331606 |
| Hospital Affiliation Ccn 1 | 381307 |
| Hospital Affiliation Lbn 1 | HARNEY DISTRICT HOSPITAL |
| Hospital Affiliation Ccn 2 | 131302 |
| Hospital Affiliation Lbn 2 | NORTH CANYON MEDICAL CENTER |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
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| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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