Provider Demographics
NPI:1871795807
Name:SACHLEBEN, BRANT COLIN (MD)
Entity type:Individual
Prefix:
First Name:BRANT
Middle Name:COLIN
Last Name:SACHLEBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CHILDREN'S WAY
Mailing Address - Street 2:SLOT 839
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3591
Mailing Address - Country:US
Mailing Address - Phone:501-364-1469
Mailing Address - Fax:501-364-1522
Practice Address - Street 1:1 CHILDREN'S WAY
Practice Address - Street 2:SLOT 839
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3591
Practice Address - Country:US
Practice Address - Phone:501-364-1469
Practice Address - Fax:501-364-1522
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-8702207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR360356YJJGMedicare PIN