Individual
DR. THOMAS WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
390 E LONGVIEW ST, FAYETTEVILLE, AR 72703-4618
(479) 442-0144
(479) 442-4557
Mailing address
390 E LONGVIEW ST, FAYETTEVILLE, AR 72703-4618
(479) 442-0144
(479) 442-4557
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
E2371
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E2371
AR LICENSE
AR
Enumeration date
02/13/2006
Last updated
03/22/2016
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