Provider Demographics
NPI:1619945714
Name:EMERY, ROBERT THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:EMERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 VIRGINIA DR
Mailing Address - Street 2:STE A
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7317
Mailing Address - Country:US
Mailing Address - Phone:870-698-1846
Mailing Address - Fax:870-793-2463
Practice Address - Street 1:501 VIRGINIA DR
Practice Address - Street 2:STE A
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7317
Practice Address - Country:US
Practice Address - Phone:870-698-1846
Practice Address - Fax:870-793-2463
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC8426208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR126455001Medicaid
AR126455001Medicaid
F92664Medicare UPIN