Individual
DR. BRADLEY RAY BIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
49 HIGHWAY 62 412, ASH FLAT, AR 72513-9594
(870) 994-7301
(870) 994-7488
Mailing address
49 HIGHWAY 62 412, ASH FLAT, AR 72513-9594
(870) 994-7301
(870) 994-7488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-4136
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155872001
—
AR
Enumeration date
06/04/2006
Last updated
05/18/2011
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