# DOC NETWORK, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518249929
- **Authorized official:** DR. BRIAN W. GRANTHAM M.D. (PRESIDENT)
- **Authorized official phone:** (800) 568-1441

## Contact information

- **Practice address:** 3601 NW CREEKSTONE BLVD, BENTONVILLE, AR 72712-8672
- **Practice address phone:** (800) 568-1441
- **Practice address fax:** (866) 614-8297
- **Mailing address:** 3601 NW CREEKSTONE BLVD, BENTONVILLE, AR 72712-8672
- **Mailing address phone:** (800) 568-1441
- **Mailing address fax:** (866) 614-8297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | E5998 | AR | — |
| 207Q00000X | Family Medicine Physician | E5998 | AR | — |
| 208D00000X | General Practice Physician | E5998 | AR | Yes |

## Other

- **Enumeration date:** 09/12/2011
- **Last updated:** 07/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 178393001 | — | AR |
| 01 | — | 5H426 | BLUE CROSS BLUE SHIELD | AR |