Organization
FRANK G THIBAULT MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK G THIBAULT MD (OWNER)
(501) 315-7774
Entity
Organization
Contact information
Practice address
910 N EAST ST, BENTON, AR 72015-3327
(501) 315-7774
(501) 315-7772
Mailing address
910 N EAST ST, BENTON, AR 72015-3327
(501) 315-7774
(501) 315-7772
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105455001
—
AR
01
—
E2094
ELECTRONIC SUBMITTER
AR
Enumeration date
04/16/2007
Last updated
09/19/2008
Update your record
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