Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | E-8702 | AR |
NPI | 1871795807 |
---|---|
Provider Name | Brant Colin Sachleben |
First Address | Little Rock, AR 72202-3591 |
Second Address | Little Rock, AR 72202-3591 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 09/03/2017 |