Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | C5734 | AR |
NPI | 1144298845 |
---|---|
Provider Name | Dr. Thomas E Cheyne |
First Address | Fort Smith, AR 72917-1230 |
Second Address | Fort Smith, AR 72903-6248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 14/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0464691 | CIGNA (01) | AR |
0920084 | UNITED HEALTHCARE (01) | AR |
100076850A | OKLAHOMA MEDICAID (01) | OK |
101905001 | (05) | AR |
17637000000 | QUALCHOICE (01) | AR |
200038811 | RAILROAD MEDICAE (01) | AR |
4613344 | AETNA (01) | AR |
50998 | ARKANSAS BLUE CROSS (01) | AR |
904221 | USA MCO (01) | AR |
C67998 | (02) | AR |