MEDICARE: JAMES EDWARD THOMAS M.D.

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	2084N0400X	Neurology Physician	E2010	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	130021238	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5L029G428	OTHER		PTAN
2	18328000000	OTHER		QUALCHOICE
3	7115035	OTHER	AR	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174672356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EDWARD THOMAS M.D.

Provider Business Mailing Address
First Line	:	1000 HWY 35 N.
Second Line	:	SUITE 5
City	:	BENTON
State	:	AR
Zip	:	72019-2351
Country	:	US
Telephone Number	:	501-315-1117
Fax Number	:	501-315-2408

Provider Business Practice Location Address
First Line	:	1000 HWY 35 N.
Second Line	:	SUITE 5
City	:	BENTON
State	:	AR
Zip	:	72019-2351
Country	:	US
Telephone Number	:	501-315-1117
Fax Number	:	501-315-2408

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	05/19/2011

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Directions to “ JAMES EDWARD THOMAS M.D.” Practice Location

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