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Individual

DR. FRANK G THIBAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
910 N EAST ST, BENTON, AR 72015-3327
(501) 315-7774
(501) 315-7772
Mailing address
910 N EAST ST, BENTON, AR 72015-3327
(501) 315-7774
(501) 315-7772

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C4061
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105455001
AR
Enumeration date
12/27/2006
Last updated
06/29/2008
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