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1699755942

NPI Code Detail

MEDICARE: MARK S. THOMAS M.D.

MEDICARE: MARK S. 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	207Q00000X	Family Medicine Physician	E-0779	AR
2	2080H0002X	Pediatric Hospice and Palliative Medicine Physician	E-0779	AR
3	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	E-0779	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080102352	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	341359	OTHER	AR	HEALTHLINK
3	5J987	OTHER	AR	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	991261	OTHER	AR	UNITED HEALTH CARE
6	1143438	OTHER	AR	FIRST HEALTH
7	16642000000	OTHER	AR	QUAL CHOICE
8	4250606	OTHER	AR	AETNA

General Provider Information

NPI Number	:	1699755942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S. THOMAS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	LOWELL
State	:	AR
Zip	:	72745-0550
Country	:	US
Telephone Number	:	479-463-7775
Fax Number	:	479-463-7187

Provider Business Practice Location Address
First Line	:	3215 N NORTHHILLS BLVD
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-4424
Country	:	US
Telephone Number	:	479-463-7102
Fax Number	:	479-463-7864

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	09/07/2017

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Directions to “ MARK S. THOMAS M.D.” Practice Location

Language	Start Address	Practice Location

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