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NPI Code Detail

MEDICARE: DR. LAWRENCE F BRADEN M.D.

MEDICARE:  DR. LAWRENCE F BRADEN  M.D.
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
1207Q00000XFamily Medicine PhysicianC5811AR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4080070820OTHERARRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000167122306OTHERUNITED HEALTH CARE
2770078401OTHERARBREASTCARE
313271000000OTHERARQUALCHOICE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
65271038OTHERAETNA

General Provider Information

NPI Number : 1447223060
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAWRENCE F BRADEN M.D.
Provider Business Mailing Address
First Line : PO BOX 757
Second Line :
City : CAMDEN
State : AR
Zip : 71711-0757
Country : US
Telephone Number : 870-836-8101
Fax Number :
Provider Business Practice Location Address
First Line : 353 CASH RD SW
Second Line :
City : CAMDEN
State : AR
Zip : 71701-3704
Country : US
Telephone Number : 870-836-8101
Fax Number : 870-837-6833
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 10/03/2008

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Directions to “ DR. LAWRENCE F BRADEN M.D.” Practice Location

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