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Individual

CLAY B BRASHEARS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
722 N MAIN ST, BENTON, AR 72015-3337
(501) 315-0059
(501) 315-1320
Mailing address
722 N MAIN ST, BENTON, AR 72015-3337
(501) 315-0059
(501) 315-1320

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-1155
AR
208000000X
Pediatrics Physician
E-1155
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137423001
AR
01
18428000000
QUALCHOICE
AR
01
1941357
UNITED HEALTHCARE
AR
01
26654584
CIGNA
AR
01
7995117
AETNA
AR
01
P00063917
RAILROAD MEDICARE
AR
Enumeration date
07/13/2005
Last updated
05/19/2021
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