Healthcare Provider Details

I. General information

NPI: 1053384974
Provider Name (Legal Business Name): THOMAS D CONLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 SPRINGHILL ST 1035
NORTH LITTLE ROCK AR
72117
US

IV. Provider business mailing address

3343 SPRINGHILL ST 1035
NORTH LITTLE ROCK AR
72117
US

V. Phone/Fax

Practice location:
  • Phone: 501-975-7676
  • Fax: 501-975-0653
Mailing address:
  • Phone: 501-975-7676
  • Fax: 501-537-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC7256
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: