Provider Demographics
NPI:1013281609
Name:THOMAS, JEFF RYAN (PA)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:RYAN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1300 CENTERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4349
Mailing Address - Country:US
Mailing Address - Phone:501-219-8900
Mailing Address - Fax:501-537-1875
Practice Address - Street 1:4200 STOCKTON DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2915
Practice Address - Country:US
Practice Address - Phone:501-945-2121
Practice Address - Fax:501-955-9073
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARPT1211363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical