Provider Demographics
NPI:1346551314
Name:BAUER, THURSTON MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:THURSTON
Middle Name:MATTHEW
Last Name:BAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10100 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6202
Mailing Address - Country:US
Mailing Address - Phone:501-255-6336
Mailing Address - Fax:501-255-6409
Practice Address - Street 1:5 SAINT VINCENT CIR
Practice Address - Street 2:SUITE 501
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5412
Practice Address - Country:US
Practice Address - Phone:501-666-2894
Practice Address - Fax:501-666-9017
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-9804208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)