| Doctor Name: | LARRY BRUCE BRASHEARS |
| NPI Number: | 1831110758 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C3174 |
| Business Practice Address: | 1234 S Main St Malvern, AR - 721045226 |
| Business Phone Number: | 5013325245 |
| Business Fax Number: | 5013374137 |
| Mailing Address: | 1234 S Main St, MALVERN |
| State: | AR |
| Postal Code: | 721045226 |
| Phone Number: | 5013325245 |
| Fax Number: | 5013374137 |
| NPI Enumeration Date: | 07/23/2006 |
| NPI Last Update Date: | 11/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C3174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |