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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972908804 NPPES
Arkansas MEDICAID 204765721

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