Dr Thomas E Harris, MD | |
1188 N Salem Rd, Suite 6, Fayetteville, AR 72704-8807 | |
(479) 442-0006 | |
(479) 442-3038 |
Full Name | Dr Thomas E Harris |
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Gender | Male |
Speciality | Family Medicine |
Location | 1188 N Salem Rd, Fayetteville, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477665446 | NPI | - | NPPES |
152003 | Other | BLUE CROSS MO | |
207954710 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 107345 (Missouri) | Secondary |
207Q00000X | Family Medicine | C-6832 (Arkansas) | Primary |
Entity Name | Circle Of Life |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386755460 PECOS PAC ID: 9335102896 Enrollment ID: O20101229000024 |
Mailing Address | Practice Location Address |
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Dr Thomas E Harris, MD Po Box 1523, Fayetteville, AR 72702-1523 Ph: (479) 571-6038 | Dr Thomas E Harris, MD 1188 N Salem Rd, Suite 6, Fayetteville, AR 72704-8807 Ph: (479) 442-0006 |
Mr. Eric P B Goodspeed, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 3215 N Northhills Blvd, Fayetteville, AR 72703 Phone: 479-463-7102 Fax: 479-463-7864 | |
Dustin Hoover, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 767 W North St, Fayetteville, AR 72701 Phone: 479-966-5088 Fax: 479-282-0469 | |
Dr. Larry D Coker, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3399 Black Forest Dr, Suite 2, Fayetteville, AR 72704 Phone: 479-757-5056 Fax: 479-757-5057 | |
Dr. Carol A Fossey, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 525 N Garland Ave, Fayetteville, AR 72701 Phone: 479-575-6479 Fax: 479-575-8793 | |
Alfred Y Gordon, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3340 N College Ave Ste 5, Fayetteville, AR 72703 Phone: 479-443-3536 Fax: 479-443-3933 | |
Stanley Bradley, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 325 E Longview Street, Fayetteville, AR 72703 Phone: 479-463-7385 Fax: 479-444-7120 | |
Miss Marielie Heidi Agesilas, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1125 N College Ave, Fayetteville, AR 72703 Phone: 479-521-8260 |