Short, Bradley Mark
Short, Bradley Mark is an individual health care provider with primary practice located at 3905 Brooken Hill Dr , Fort Smith AR 72908-9282. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Short, Bradley Mark can be contacted via phone (479) 646-3345.Contact Information
Primary practice address
3905 Brooken Hill Dr
Fort Smith AR 72908-9282
Phone: (479) 646-3345
Fax: (479) 646-6049
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | C7559 | Arkansas |
Profile Details
| NPI number | 1568404598 |
|---|---|
| LBN Legal business name | Short, Bradley Mark |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Dec 1st, 2010 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568404598 | NPPES |
| Arkansas | MEDICAID | 121453001 |
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