Tillman, Bradley
Tillman, Bradley is an sole proprietor health care provider with primary practice located at 610 W Grand Ave , Hot Springs AR 71901-3922. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as his primary health care specialty. Tillman, Bradley can be contacted via phone (501) 625-7800.Contact Information
Primary practice address
610 W Grand Ave
Hot Springs AR 71901-3922
Phone: (501) 625-7800
Fax: (501) 325-2727
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | PT3770 | Arkansas |
Profile Details
NPI number | 1972908804 |
---|---|
LBN Legal business name | Tillman, Bradley |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 4th, 2014 |
Last updated | Nov 4th, 2014 - about 11 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 | 1972908804 | NPPES |
Arkansas | MEDICAID | 204765721 |
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