Phillips, Tracy Thomas
Phillips, Tracy Thomas is an sole proprietor health care provider with primary practice located at 2001 Club Manor Dr Ste S , Maumelle AR 72113-7417. He recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Phillips, Tracy Thomas can be contacted via phone (501) 734-8085.Contact Information
Primary practice address
2001 Club Manor Dr Ste S
Maumelle AR 72113-7417
Phone: (501) 734-8085
Fax: (501) 734-8088
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / Primary Care | 261QP2300X | E1018 | Arkansas |
Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | E-1018 | Arkansas |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E1018 | Arkansas |
Profile Details
NPI number | 1679571863 |
---|---|
LBN Legal business name | Phillips, Tracy Thomas |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 12th, 2005 |
Last updated | May 29th, 2024 - about 4 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1679571863 | NPPES |
Arkansas | MEDICAID | 129995003 | |
Arkansas | Other | 2Z0853 |
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