| Mr Branson B Bolden, MD | |
|
1 Childrens Way # 512-1, Little Rock, AR 72202-3500 | |
| (013) 644-5255 | |
| (501) 364-5246 |
| Full Name | Mr Branson B Bolden |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1 Childrens Way # 512-1, Little Rock, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932376316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | E-6996 (Arkansas) | Primary |
| Entity Name | University Of Arkansas For Medical Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346230968 PECOS PAC ID: 4082528955 Enrollment ID: O20040115000431 |
| Entity Name | Arkansas Childrens Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598773079 PECOS PAC ID: 2769477744 Enrollment ID: O20040419000796 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Branson B Bolden, MD 1 Childrens Way # 653, Little Rock, AR 72202-3500 Ph: (501) 364-1100 | Mr Branson B Bolden, MD 1 Childrens Way # 512-1, Little Rock, AR 72202-3500 Ph: (013) 644-5255 |
Dr. Michael William Bishop, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way Fl Wing1, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082 | |
Amber Michele Morse, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-16, Little Rock, AR 72202 Phone: 501-364-1050 Fax: 501-364-6931 | |
Dustin Edward Williford, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-8, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-2963 | |
Kristyn N Jeffries, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-5262 Fax: 501-364-3418 | |
Thanh Thanh Dai, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-24a, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082 | |
Indirapriya Darshini Avulakunta, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-5262 Fax: 501-364-3418 | |
Abdelrahman Masri, Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082 |