Individual
MARK S. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3215 N NORTHHILLS BLVD, FAYETTEVILLE, AR 72703-4424
(479) 463-7102
(479) 463-7864
Mailing address
PO BOX 550, LOWELL, AR 72745-0550
(479) 463-7775
(479) 463-7187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E-0779
AR
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
E-0779
AR
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
E-0779
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080102352
RAILROAD MEDICARE
AR
01
—
1143438
FIRST HEALTH
AR
05
—
128927001
—
AR
01
—
16642000000
QUAL CHOICE
AR
01
—
341359
HEALTHLINK
AR
01
—
4250606
AETNA
AR
01
—
5J987
BCBS
AR
01
—
991261
UNITED HEALTH CARE
AR
Enumeration date
01/20/2006
Last updated
09/07/2017
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