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Individual

DR. THOMAS ROBERT MOFFETT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11300 N RODNEY PARHAM RD, SUITE 210, LITTLE ROCK, AR 72212-4153
(501) 663-4100
(501) 663-4145
Mailing address
11300 N RODNEY PARHAM RD, SUITE 210, LITTLE ROCK, AR 72212-4153
(501) 663-4100
(501) 663-4145

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
R4045
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117396001
AR
01
11923000000
QUALCHOICE
AR
Enumeration date
08/02/2005
Last updated
10/17/2024
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