| Bradley Bibb Md Pllc | |
|
3519 Highway 63 Black Rock AR 72415 | |
| (870) 878-4005 | |
| (870) 994-7488 |
| Full Name | Bradley Bibb Md Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3519 Highway 63, Black Rock, Arkansas |
| Authorized Official Name and Position | Monya York (DIRECTOR CREDENTIALING) |
| Authorized Official Contact | 8708561202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Bibb Md Pllc 4196 Highway 62 412 Ste A Hardy AR 72542-8002 Ph: () - | Bradley Bibb Md Pllc 3519 Highway 63 Black Rock AR 72415 Ph: (870) 878-4005 |
| NPI Number | 1437569837 |
|---|---|
| Provider Enumeration Date | 05/07/2014 |
| Last Update Date | 01/28/2026 |
| Medicare PECOS PAC ID | 4789715285 |
|---|---|
| Medicare Enrollment ID | O20140716000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437569837 | NPI | - | NPPES |
| 204416002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |