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NPI Code Detail

MEDICARE: TOM UMPHRESS

MEDICARE: TOM UMPHRESS
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
1103T00000XPsychologist76-19EIAR

General Provider Information

NPI Number : 1205137692
Entity Type Code : Individual
Provider Name (Legal Business Name) : TOM UMPHRESS
Provider Business Mailing Address
First Line : 3307 N DIXIELAND RD
Second Line :
City : ROGERS
State : AR
Zip : 72756-6816
Country : US
Telephone Number : 479-986-5150
Fax Number :
Provider Business Practice Location Address
First Line : 3307 N DIXIELAND RD
Second Line :
City : ROGERS
State : AR
Zip : 72756-6816
Country : US
Telephone Number : 479-986-5150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2010
Last Update Date : 11/16/2010

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Directions to “ TOM UMPHRESS ” Practice Location

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