BRADLEY FOOTCARE LLC; NPI #1477881092

Contact Information

BRADLEY FOOTCARE LLC

116 W. TYLER AVE
STE. B
WEST MEMPHIS, AR 72301

Phone: 901-417-1692
Fax: 870-733-0889
Website: http://www.bradleyfootcare.com

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgery, Foot & Ankle	213ES0103X	48	Podiatry

Indicates primary specialty

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NPI Profile & details for BRADLEY FOOTCARE LLC

NPI # 1477881092

LBN Legal business name BRADLEY FOOTCARE LLC

Authorized official JESSE BRADLEY - (PODIATRIST)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/19/2009

Last updated 07/22/2020 - About 6 years ago

Identifiers

AR	License #	242
AR	Medicaid	180310717
AR	Medicaid	180372748
AR	Medicaid	199945716

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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BRADLEY FOOTCARE LLC

Contact Information

Specialty

Surgery, Foot & Ankle

NPI Profile & details for BRADLEY FOOTCARE LLC

Reviews for BRADLEY FOOTCARE LLC