Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | C-8148 | AR |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | C8148 | AR |
NPI | 1689684235 |
---|---|
Provider Name | Steven L Thomason |
First Address | Springdale, AR 72764-4634 |
Second Address | Springdale, AR 72764-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 05/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
120439001 | (05) | AR |
F02316 | (02) |