Individual
DR. THOMAS E. HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1188 N SALEM RD, SUITE 6, FAYETTEVILLE, AR 72704-8807
(479) 442-0006
(479) 442-3038
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
107345
MO
207Q00000X
Family Medicine Physician
Primary
C-6832
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152003
BLUE CROSS MO
—
05
—
207954710
—
MO
Enumeration date
08/31/2006
Last updated
11/13/2013
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