Individual
DR. BRADLEY MARK SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3905 BROOKEN HILL DR, FORT SMITH, AR 72908-9282
(479) 646-3345
(479) 646-6049
Mailing address
3905 BROOKEN HILL DR, FORT SMITH, AR 72908-9282
(479) 646-3345
(479) 646-6049
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
C7559
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121453001
—
AR
Enumeration date
06/12/2006
Last updated
12/01/2010
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