Individual
BRADLEY SCOTT BOOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 221-0295
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(501) 227-8000
(501) 221-0295
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
C7662
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127655001
—
AR
01
—
682288
MEDICARE ID# FOR CHI ST. VINCENT LITTLE ROCK DIAGNOSTIC CLINIC
AR
Enumeration date
06/24/2006
Last updated
04/17/2019
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