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NPI Code Detail

MEDICARE: THOMAS T STINNETT BA, MHPP

MEDICARE: THOMAS T STINNETT BA, MHPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1497828651
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS T STINNETT BA, MHPP
Provider Business Mailing Address
First Line : 650 S SHACKLEFORD RD
Second Line : SUITE 217
City : LITTLE ROCK
State : AR
Zip : 72211-3522
Country : US
Telephone Number : 501-221-1843
Fax Number : 501-221-2376
Provider Business Practice Location Address
First Line : 4354 STOCKTON DR
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2917
Country : US
Telephone Number : 501-955-7600
Fax Number : 501-955-7612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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