Provider Demographics
NPI:1164418679
Name:TOMPKINS, GEORGE HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:HENRY
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-3921
Mailing Address - Country:US
Mailing Address - Phone:479-474-7771
Mailing Address - Fax:479-474-3552
Practice Address - Street 1:400 FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-3502
Practice Address - Country:US
Practice Address - Phone:479-474-7771
Practice Address - Fax:479-474-3552
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE0883OtherAR LICENSE
ARE0883OtherAR LICENSE
ARE73086Medicare UPIN
ARBT8737100OtherDEA