Provider Demographics
NPI:1053384974
Name:CONLEY, THOMAS D (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:CONLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3343 SPRINGHILL
Mailing Address - Street 2:ST 1035
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117
Mailing Address - Country:US
Mailing Address - Phone:501-975-7676
Mailing Address - Fax:501-537-0206
Practice Address - Street 1:3343 SPRINGHILL
Practice Address - Street 2:ST 1035
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117
Practice Address - Country:US
Practice Address - Phone:501-975-7676
Practice Address - Fax:501-975-0653
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC7256207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARCC6745OtherRAILROAD MEDICARE
ARCN1884OtherRAILROAD MEDICARE
AR114332001Medicaid
AR50992OtherBLUE CROSS BLUE SHIELD
B90058Medicare UPIN
AR114332001Medicaid