MEDICARE: THOMAS L. EANS, MD

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
1	208D00000X	General Practice Physician	C5049	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	51496	OTHER	AR	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144283169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS L. EANS, MD

Provider Business Mailing Address
First Line	:	11749 MAUMELLE BOULEVARD
Second Line	:
City	:	NO LITTLE ROCK
State	:	AR
Zip	:	72113
Country	:	US
Telephone Number	:	501-663-3732
Fax Number	:	501-663-0076

Provider Business Practice Location Address
First Line	:	11749 MAUMELLE BOULEVARD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113
Country	:	US
Telephone Number	:	501-663-3732
Fax Number	:	501-663-0076

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS L EANS
Credential	:	MD
Telephone Number	:	501-663-3732

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	03/30/2009

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