Individual
DR. MARY DENISE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
E 150 SIEBENMORGAN RD, CONWAY, AR 72032
(504) 329-6851
Mailing address
E 150 SIEBENMORGAN RD, CONWAY, AR 72032
(504) 329-6851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N6732
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103762003
—
AR
01
—
N6732
LICENSE
AR
Enumeration date
07/19/2006
Last updated
07/08/2007
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