Individual
DR. THOMAS S ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 WESTERN AVE STE 302, CONWAY, AR 72034
(501) 504-6649
Mailing address
550 CLUB LANE, SUITE1, CONWAY, AR 72034-3681
(501) 329-1510
(501) 329-5698
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
R3271
AR
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
R3271
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114409001
—
AR
05
—
114652002
—
AR
01
—
12592000000
QUALCHOICE
AR
01
—
200011968
RR MEDICARE
AR
01
—
51490
BCBS
AR
Enumeration date
08/19/2005
Last updated
08/03/2018
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