Bradley, Sam B
Bradley, Sam B is an sole proprietor health care provider with primary practice located at 500 N 6Th St , Fort Smith AR 72901-2006. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bradley, Sam B can be contacted via phone (479) 782-7272.Contact Information
Primary practice address
500 N 6Th St
Fort Smith AR 72901-2006
Phone: (479) 782-7272
Fax: (479) 782-7476
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2229 | Arkansas |
Profile Details
| NPI number | 1669445102 |
|---|---|
| LBN Legal business name | Bradley, Sam B |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Mar 14th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669445102 | NPPES |
| Arkansas | MEDICAID | 105771722 | |
| Arkansas | Other | 0317710007 | |
| Arkansas | MEDICAID | 100760710A | |
| Arkansas | Other | 48940 |
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