Phillips, Tracy Thomas

Phillips, Tracy Thomas is an sole proprietor health care provider with primary practice located at 2001 Club Manor Dr Ste S , Maumelle AR 72113-7417. He recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Phillips, Tracy Thomas can be contacted via phone (501) 734-8085.

Contact Information

Primary practice address
2001 Club Manor Dr Ste S Maumelle AR 72113-7417
Phone: (501) 734-8085
Fax: (501) 734-8088
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X E1018 Arkansas
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X E-1018 Arkansas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E1018 Arkansas

Profile Details

NPI number 1679571863
LBN Legal business name Phillips, Tracy Thomas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated May 29th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679571863 NPPES
Arkansas MEDICAID 129995003
Arkansas Other 2Z0853

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