Provider Demographics
NPI:1841250875
Name:THRASHER, JAMES RANDALL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RANDALL
Last Name:THRASHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:R
Other - Last Name:THRASHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11400 HURON LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1847
Mailing Address - Country:US
Mailing Address - Phone:501-666-3666
Mailing Address - Fax:501-907-9069
Practice Address - Street 1:11400 HURON LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1847
Practice Address - Country:US
Practice Address - Phone:501-666-3666
Practice Address - Fax:501-907-9069
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-1678207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136677001Medicaid
ARG71478Medicare UPIN