Organization
THOMAS NEUROLOGY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES EDWARD THOMAS MD (OWNER/PRESIDENT)
(501) 315-1117
Entity
Organization
Contact information
Practice address
1000 HIGHWAY 35 N, SUITE 5, BENTON, AR 72019-2351
(501) 315-1117
(501) 315-2408
Mailing address
1000 HIGHWAY 35 N, SUITE 5, BENTON, AR 72019-2351
(501) 315-1117
(501) 315-2408
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
E2010
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124224001
—
AR
01
—
18328000000
QUALCHOICE
—
01
—
5G428
PTAN
—
01
—
7115035
AETNA
—
01
—
DP8413
RAILROAD MEDICARE
AR
Enumeration date
01/25/2010
Last updated
01/31/2011
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