Individual
BRADY STUBBLEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
915 E MARKET AVE, SEARCY, AR 72149-5615
(501) 279-5642
Mailing address
456 N NEW BALLAS RD STE 118, SAINT LOUIS, MO 63141-6812
(314) 567-1400
(314) 567-9559
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023006828
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/05/2019
Last updated
03/30/2023
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