Individual
BROOKE A BISBEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
200 S. 20TH STREET, SUITE B, ROGERS, AR 72758-4470
(479) 636-9393
(479) 636-9341
Mailing address
200 S. 20TH STREET, SUITE B, ROGERS, AR 72758-4470
(479) 636-9393
(479) 636-9341
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
190
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146125748
—
AR
01
—
4746160001
DMERC
—
01
—
480031869
RR MEDICARE
—
01
—
5W274
BCBS
—
Enumeration date
09/26/2005
Last updated
01/03/2012
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