Provider Demographics
NPI:1659326916
Name:PIERCE, W BRADLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:W
Middle Name:BRADLEY
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9601 LILE DR
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6333
Mailing Address - Country:US
Mailing Address - Phone:501-227-5256
Mailing Address - Fax:501-227-9151
Practice Address - Street 1:9601 LILE DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6333
Practice Address - Country:US
Practice Address - Phone:501-227-5256
Practice Address - Fax:501-227-9151
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARR-41622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR119183001Medicaid
AR119183001Medicaid
ARE17090Medicare UPIN