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1225089204

NPI Code Detail

MEDICARE: GERALD BRADLEY SCHAEFER MD

MEDICARE: GERALD BRADLEY SCHAEFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207SG0201X	Clinical Genetics (M.D.) Physician	18185	NE
2	2080P0205X	Pediatric Endocrinology Physician	E5822	AR
3	2080P0205X	Pediatric Endocrinology Physician	18185	NE
4	207SG0201X	Clinical Genetics (M.D.) Physician	E5822	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225089204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD BRADLEY SCHAEFER MD

Provider Business Mailing Address
First Line	:	1 CHILDRENS WAY # 653
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-364-4082

Provider Business Practice Location Address
First Line	:	2601 GENE GEORGE BLVD
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-0845
Country	:	US
Telephone Number	:	479-725-6880
Fax Number	:	479-725-6582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	10/04/2018

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Directions to “ GERALD BRADLEY SCHAEFER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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