Individual
JOHN THEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
E-4569
AR
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
E-4569
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157527001
—
AR
01
—
P00232691
RAILROAD MEDICARE
AR
Enumeration date
10/18/2006
Last updated
03/06/2008
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