Individual
JIM ED BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
722 N MAIN ST, BENTON, AR 72015
(501) 315-0059
(501) 315-0083
Mailing address
722 N MAIN ST, BENTON, AR 72015
(501) 315-0059
(501) 315-0083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-3951
AR
208000000X
Pediatrics Physician
E-3951
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154130001
—
AR
Enumeration date
04/21/2006
Last updated
05/19/2021
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