MEDICARE: DR. THOMAS G INMAN D.D.S.

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	1223G0001X	General Practice Dentistry	2678	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56567	OTHER	AR	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942414461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS G INMAN D.D.S.

Provider Business Mailing Address
First Line	:	513 N WILLIAMS
Second Line	:
City	:	CARLISLE
State	:	AR
Zip	:	72024-1514
Country	:	US
Telephone Number	:	870-552-3500
Fax Number	:	870-552-3961

Provider Business Practice Location Address
First Line	:	513 N WILLIAMS
Second Line	:
City	:	CARLISLE
State	:	AR
Zip	:	72024-1514
Country	:	US
Telephone Number	:	870-552-3500
Fax Number	:	870-552-3961

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	09/28/2012

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