Provider Demographics
NPI:1831190339
Name:HOLLIS, THOMAS H JR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:HOLLIS
Suffix:JR
Gender:M
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: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:501-627-1800
Mailing Address - Fax:501-627-1899
Practice Address - Street 1:1 MERCY LN
Practice Address - Street 2:SUITE 201
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6442
Practice Address - Country:US
Practice Address - Phone:501-609-2222
Practice Address - Fax:501-321-9689
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1842208M00000X
ARE 1842207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136240001Medicaid
AR136240001Medicaid
AR136240001Medicaid