J. BROADWATER (NPI# 1043300619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043300619 |
| Entity Type | Individual |
| Full Name | J. BROADWATER |
| Credential | MD |
| Practice Address |
4301 W Markham St # 783 Little Rock AR 72205-7101 |
| Practice Telephone | 5016868000 |
| Mailing Telephone | 5016868000 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
C-6025 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
4301 W MARKHAM ST # 783 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72205-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518960194 | Dennis E Mcdonnell | Neurological Surgery | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2005-05-27 |
| 1255931226 | Satya Narayana Patro | Radiology | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-10-29 |
| 1962019182 | Houston Cotton | Physician Assistant | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-09-30 |
| 1144836495 | Andrea Barnes | Nurse Practitioner | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-09-22 |
| 1053927012 | Abigail E Nichols | Advanced Practice Midwife | 4301 W Markham St # 783, Little Rock, AR 72205-7199 | 2020-09-16 |
| 1629682653 | Christina Mantione | Social Worker | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-09-08 |
| 1467065250 | Christina Louise Rone | Registered Nurse | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-08-31 |
| 1700499506 | Asjia Johnson | Nurse Practitioner | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-08-31 |
| 1982215968 | Brooke Kathlen Lea | Nurse Practitioner | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-08-12 |
| 1003424243 | Rachel Sloan | Nurse Practitioner | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2020-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
| 1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
| 1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
| 1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
| 1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
| 1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
| 1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
| 1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
| 1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
| 1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
| Find all providers in zip 72205 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477964278 | Christopher James Jean-louis | Surgery | 4301 W Markham St # 725, Little Rock, AR 72205-7101 | 2014-05-14 |
| 1649387689 | Nicholas Paul Lang | Surgery | 4301 W Markham St # 728, Little Rock, AR 72205-7101 | 2006-08-24 |
| 1932350683 | Juan Camilo Barreto Andrade | Surgery | 4301 W Markham St, Slot 520, Little Rock, AR 72205-7101 | 2008-09-30 |
| 1215187083 | Marian C Miller | Surgery | 8901 Carti Way, Little Rock, AR 72205-6523 | 2008-09-29 |
| 1861582439 | Anne Mancino | Surgery | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-10-13 |
| 1922108232 | Brian D. Badgwell | Surgery | 4301 W Markham St, #725, Little Rock, AR 72205-7101 | 2006-09-25 |
| 1215942198 | Ronda Shirletta Henry-tillman | Surgery | 4301 W Markham St, Slot 725, Little Rock, AR 72205-7101 | 2006-07-30 |
| City | LITTLE ROCK |
| Zip Code | 72205 |
Please comment or provide details below to improve the information on J. BROADWATER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.