Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edward Willard Bradshaw III, PA-C

Individual provider Surgical Physician Assistant · NPI 1235192774

Edward Willard Bradshaw III, PA-C is a Surgical Physician Assistant in Lake Havasu City, Arizona. Licensed in Arizona and Florida. Registered with an NPI since 2006.

Licensed in
AZ, FL
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

72 Lake Havasu Ave S Ste 102
Lake Havasu City, AZ 86403-0857
Phone: (928) 453-2211
Fax: (928) 453-2213
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5357 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA2576 (FL)

Record details

NPI number1235192774
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 7, 2006
Last updated in NPPESJune 29, 2020
Certification dateJune 29, 2020

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