Chism, Brandon S
Chism, Brandon S is an individual health care provider with primary practice located at 3211 N Northhills Blvd Suite 110, Fayetteville AR 72703-4007. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Chism, Brandon S can be contacted via phone (479) 571-4338.Contact Information
Primary practice address
3211 N Northhills Blvd Suite 110
Fayetteville AR 72703-4007
Phone: (479) 571-4338
Fax: (479) 571-4015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 35183 | Arizona |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | E-4651 | Arkansas |
Profile Details
| NPI number | 1376500108 |
|---|---|
| LBN Legal business name | Chism, Brandon S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Jun 28th, 2012 - about 12 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 | 1376500108 | NPPES |
| Arizona | Other | P00381947 | RAILROAD MEDICARE |
| Arizona | MEDICAID | 090498 | RAILROAD MEDICARE |
| Arizona | Other | E-4651 | RAILROAD MEDICARE |
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