NPI 1114160389

Jesse H. Bradley, DPM

Practitioner Foot & Ankle Surgery Podiatrist West Memphis, AR

Practice location

Address: 116 W Tyler Ave Suite B, West Memphis, AR 72301-4221
Phone: (870) 733-0888
Fax: (870) 733-0889
Mailing address: PO Box 1752, West Memphis, AR 72303-1752

Registered specialties (4)

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 242 (AR)

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Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 80197 (MS)

Foot & Ankle Surgery Podiatrist

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 2007024292 (MO)

Foot & Ankle Surgery Podiatrist

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence 695 (TN)

Registry record

NPI: 1114160389
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2009
Record last updated: 22 Jul 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.