DR. BRADLEY CANADA DINER M.D. - NPI 1194793398 - Psychiatry & Neurology in Little Rock, AR

Q: What is Bradley Diner's NPI number?

The NPI number for Bradley Diner is 1194793398. It was assigned to this individual provider in the NPPES registry on March 14, 2006. The provider is also known as Dr. Bradley Canada Diner MD.

Q: What is Bradley Diner's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Diner was last updated on March 18, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Bradley Canada Diner M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRADLEY CANADA DINER M.D. (NPI 1194793398) is an individual psychiatry provider in Little Rock, Arkansas, licensed in Arkansas (C6817) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1194793398

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameDR. BRADLEY CANADA DINERCredential: M.D.

Location Address4 EXECUTIVE CENTER CTLittle Rock, AR 72211-4487

Mailing Address4 Executive Center CtLittle Rock, AR 72211-4487 · (501) 448-0060 · Fax (501) 448-0066

Phone(501) 448-0060

Fax(501) 448-0066

Sole ProprietorNo

Enumeration DateMarch 14, 2006

Last NPPES UpdateMarch 18, 2013

✔ NPI 1194793398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in AR · C6817

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

4 EXECUTIVE CENTER CT, Little Rock, AR 72211

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Other Names 1

Other Name (5)Dr. Bradley Canada Diner Md

Other Identifiers 5

Medicare UPIND93160AR

Medicare PIN539856738AR

Medicaid117612001AR

Other53985AR · Blue Cross Blue Shield

Medicare ID-Type Unspecified53985AR · Medicare

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICHOLE ANN WARD LMSW

Social Worker (Clinical)