Organization
THOMAS L. EANS, MD
Active
Other names
RIVERSIDE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS L EANS MD (OWNER)
(501) 663-3732
Entity
Organization
Contact information
Practice address
11749 MAUMELLE BOULEVARD, NORTH LITTLE ROCK, AR 72113
(501) 663-3732
(501) 663-0076
Mailing address
11749 MAUMELLE BOULEVARD, NO LITTLE ROCK, AR 72113
(501) 663-3732
(501) 663-0076
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
C5049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101023001
—
AR
05
—
116905002
—
AR
01
—
51496
BCBS
AR
Enumeration date
04/10/2006
Last updated
03/30/2009
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