Healthcare Provider Details

I. General information

NPI: 1124618624
Provider Name (Legal Business Name): BRADLEY DEAL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E 13TH ST
MURFREESBORO AR
71958-9541
US

IV. Provider business mailing address

PO BOX 259
MURFREESBORO AR
71958-0259
US

V. Phone/Fax

Practice location:
  • Phone: 870-285-2111
  • Fax: 870-285-3357
Mailing address:
  • Phone: 870-285-2111
  • Fax: 870-285-3357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD09667
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: