Provider Demographics
NPI:1770512857
Name:THAXTON, MARY ZIEGELMEIER (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ZIEGELMEIER
Last Name:THAXTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-321-2229
Mailing Address - Fax:501-321-2342
Practice Address - Street 1:118 WOMEN'S CENTER LANE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71903-1850
Practice Address - Country:US
Practice Address - Phone:501-609-2229
Practice Address - Fax:501-609-2342
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE6147207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178690001Medicaid
AR5H842Medicare PIN