Healthcare Provider Details

I. General information

NPI: 1588658629
Provider Name (Legal Business Name): THOMAS STUART HARRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2005
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 MASTERS PLACE DR
MAUMELLE AR
72113-7019
US

IV. Provider business mailing address

38 MASTERS PLACE DR
MAUMELLE AR
72113-7019
US

V. Phone/Fax

Practice location:
  • Phone: 501-295-3236
  • Fax: 501-295-3236
Mailing address:
  • Phone: 501-295-3236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC-3348
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: