BRADLEY FOOTCARE LLC NPI 1477881092

NPI Information

  • NPI: 1477881092
  • Provider Name: BRADLEY FOOTCARE LLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 116 W TYLER AVE STE B
    WEST MEMPHIS, AR
    ZIP 72301
  • Phone: (870) 733-0888

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NPI Details

BRADLEY FOOTCARE LLC is a foot and ankle surgery podiatrist in West Memphis, AR. BRADLEY FOOTCARE LLC NPI is 1477881092. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

116 W TYLER AVE STE B
WEST MEMPHIS, AR
ZIP 72301-221
Phone: (870) 733-0888
Fax: (870) 733-0889

The provider's authorized official is Jesse H Bradley .
The authorized official title is Podiatrist and has the following contact phone number (870) 733-0888.

The enumeration date for this NPI number is 11/19/2009 and was last updated on 7/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery242ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1180310717MEDICAIDARKANSAS
2180372748MEDICAIDARKANSAS
3199945716MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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