Individual
DR. SAM B BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
500 N 6TH ST, FORT SMITH, AR 72901-2006
(479) 782-7272
(479) 782-7476
Mailing address
500 N 6TH ST, FORT SMITH, AR 72901-2006
(479) 782-7272
(479) 782-7476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2229
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0317710007
MEDICARE NSC-GREENWOOD CLINIC
AR
05
—
100760710A
—
OK
05
—
105771722
—
AR
01
—
48940
BCBS
AR
Enumeration date
02/07/2006
Last updated
03/14/2018
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