Provider Demographics
NPI:1588658629
Name:HARRIS, THOMAS STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STUART
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:38 MASTERS PLACE DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7019
Mailing Address - Country:US
Mailing Address - Phone:501-295-3236
Mailing Address - Fax:
Practice Address - Street 1:38 MASTERS PLACE DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7019
Practice Address - Country:US
Practice Address - Phone:501-295-3236
Practice Address - Fax:501-295-3236
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-05
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-33482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARD79474Medicare UPIN