Healthcare Provider Details

I. General information

NPI: 1689684235
Provider Name (Legal Business Name): STEVEN L THOMASON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 E EMMA AVE SUITE300
SPRINGDALE AR
72764-4634
US

IV. Provider business mailing address

614 E EMMA AVE SUITE300
SPRINGDALE AR
72764-4634
US

V. Phone/Fax

Practice location:
  • Phone: 479-751-7417
  • Fax: 479-751-4898
Mailing address:
  • Phone: 479-751-7417
  • Fax: 479-751-4898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC-8148
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberC8148
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: