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General NPI Number Information
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NPI Number | 1659608669
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Entity Type | Organization
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Legal Business Name | RICHARD E. BRALEY, M.D. P.A.
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 10/11/2013
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Provider Practice Location Address
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Address Line | 1661 HIGDON FERRY RD
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71913-6913
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Country | US
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Telephone | 501-525-0790
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Fax | 501-525-9989
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Provider Business Mailing Address
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Address Line | 1661 HIGDON FERRY RD
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City | HOT SPRINGS NATIONAL PARK
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State | AR
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Zip | 71913-6913
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Country | US
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Telephone | 501-525-0790
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Fax | 501-525-9989
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD E BRALEY
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Credential | M.D.
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Telephone | 501-525-0790
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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 | R2711
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License Number State | AR
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