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NPI Code Detail

MEDICARE: JAY O BRAINARD M.D.

MEDICARE: JAY O BRAINARD 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
1207W00000XOphthalmology PhysicianC4878AR

General Provider Information

NPI Number : 1932177318
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY O BRAINARD M.D.
Provider Business Mailing Address
First Line : 5300 W. MARKHAM
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-3528
Country : US
Telephone Number : 501-664-5354
Fax Number : 501-664-5257
Provider Business Practice Location Address
First Line : 5300 W. MARKHAM
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-3528
Country : US
Telephone Number : 501-664-5354
Fax Number : 501-664-5257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 08/05/2016

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