Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | E-1610 | AR |
Y | 208200000X | Surgeon | E-1610 | AR |
Y | 208600000X | Surgeon | E-1610 | AR |
N | 2086S0122X | Plastic and Reconstructive Surgery | E-1610 | AR |
NPI | 1073644019 |
---|---|
Provider Name | Rhys Lionel Branman |
First Address | Little Rock, AR 72211 |
Second Address | Little Rock, AR 72211-4353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 19/12/2009 |