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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
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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