Healthcare Provider Details

I. General information

NPI: 1922934876
Provider Name (Legal Business Name): BRYSON HUGGINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 BRADLEY DR
MOUNTAIN HOME AR
72653-2730
US

IV. Provider business mailing address

1310 BRADLEY DR
MOUNTAIN HOME AR
72653-2730
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-4021
  • Fax: 870-424-4112
Mailing address:
  • Phone: 870-424-4021
  • Fax: 870-424-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: