NPI
Bradly Shane Holland
NPI 1619905692
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- DO
- Type
- Individual
- Enumeration date
- 2006-06-29
- Last updated
- 2024-07-31
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Specialties
Licenses
- License AR
- E5111
- License TN
- 1639
- License AR
- E-5111
Location
- Practice location
- 5208 W Village Pkwy Ste 1
- City
- Rogers AR
- Postal code
- 72758-8199
- Phone
- (479) 389-2803
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Rogers, AR. 2,490 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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