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NPI Code Detail

MEDICARE: STEPHEN A BROUGHTON MD

MEDICARE: STEPHEN A BROUGHTON MD
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
12084P0800XPsychiatry PhysicianE0252AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2F90324OTHERARUPIN

General Provider Information

NPI Number : 1861411167
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN A BROUGHTON MD
Provider Business Mailing Address
First Line : 2500 RIKE DR
Second Line :
City : PINE BLUFF
State : AR
Zip : 71603-3937
Country : US
Telephone Number : 870-534-1834
Fax Number : 870-534-5798
Provider Business Practice Location Address
First Line : 2500 RIKE DR
Second Line :
City : PINE BLUFF
State : AR
Zip : 71603-3937
Country : US
Telephone Number : 870-534-1834
Fax Number : 870-534-5798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 03/07/2023

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1356449268 — MS. SHERRY RAE RABER RN
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1598864480 — MRS. PEGGY ANN THOMPSON RN
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Directions to “ STEPHEN A BROUGHTON MD” Practice Location

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