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Individual

BRYAN HOLLAN CLARDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1301 S E ST, FORT SMITH, AR 72901-4716
(479) 785-2431
Mailing address
612 S 12TH ST, FORT SMITH, AR 72901-4702
(479) 785-2431

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-2745
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02090005200
QUALCHOICE
05
02450298
MS
01
080184879
RAILROAD MEDICARE
05
100143000A
OK
05
146720001
AR
05
1637041
LA
01
2220866
UNITED HEALTHCARE
AR
01
2674666001
CIGNA
01
5M245
BLUE CROSS/BLUE SHIELD
AR
01
7848374
AETNA
Enumeration date
06/09/2005
Last updated
03/07/2023
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