Provider Demographics
NPI:1912108945
Name:BRANMAN & DEVLIN MD PLC
Entity Type:Organization
Organization Name:BRANMAN & DEVLIN MD PLC
Other - Org Name:COSMETIC SURGERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RHYS
Authorized Official - Middle Name:LIONEL
Authorized Official - Last Name:BRANMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-227-0707
Mailing Address - Street 1:10809 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4353
Mailing Address - Country:US
Mailing Address - Phone:501-227-0707
Mailing Address - Fax:501-227-0450
Practice Address - Street 1:10809 EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4353
Practice Address - Country:US
Practice Address - Phone:501-227-0707
Practice Address - Fax:501-227-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARBB4853657174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR=========OtherFEDERAL TAX ID