Dr. Mark Standridge Bradshaw, m.d.
Family Medicine in Wynne, AR. Individual provider (NPI-1).
NPI number1346355518
StatusActive
Last updated in NPPESMar 29, 2012
Details
- NPI
- 1346355518
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark Standridge Bradshaw
- Credential
- m.d.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Mar 29, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | E-4753 | AR | Yes |
Practice location
710 Falls Blvd SWynne, AR 72396-3514
Phone 870-238-2321 · Fax 870-238-0114
Mailing address
Po Box 158Wynne, AR 72396-0158
Phone 870-238-2321 · Fax 870-238-0114
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