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General NPI Number Information
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NPI Number | 1336196260
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Entity Type | Individual
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Provider Name | RONALD ALVIN BRASWELL MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 205-329-3590
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Fax |
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Provider Business Mailing Address
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Address Line | 5710 RUMMEL RD
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4205
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Country | US
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Telephone | 205-329-3590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | U1173
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 69416
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | 11496
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License Number State | MS
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