Provider Demographics
NPI:1255384012
Name:THOMPSON, TONYA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS WAY #653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3510
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS WAY #653
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2135207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR138388001Medicaid
ARP00158024OtherRAILROAD MEDICARE
ARP00158024OtherRAILROAD MEDICARE
ARH00030Medicare UPIN
AR138388001Medicaid