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Contact Information

BRADFORD C BAISDEN, PT
823 PARK EAST BLVD STE B
LAFAYETTE, IN47905
 Phone: 765-297-0975
 Fax: 765-297-0974
 Website: http://www.eliteptsportsmedicine.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for BRADFORD C BAISDEN · (Male)

NPI Number 1659305092
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 07/10/2006
Last updated 11/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 05011714A
  • NC License # 10165
  • NC Other 079XN BCBS PROVIDER NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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