Provider Demographics
NPI:1689682353
Name:THURMAN, REGINA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ELIZABETH
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1708 E JOYCE BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5252
Mailing Address - Country:US
Mailing Address - Phone:479-301-2565
Mailing Address - Fax:479-301-2717
Practice Address - Street 1:1708 E JOYCE BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5252
Practice Address - Country:US
Practice Address - Phone:479-301-2565
Practice Address - Fax:479-301-2717
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-4490208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-4490OtherSTATE LICENSE