Provider Demographics
NPI:1811973225
Name:THRASH, JOHN P (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:THRASH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1801 WEST 40TH AVE SUITE 4-E
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603
Mailing Address - Country:US
Mailing Address - Phone:870-535-4850
Mailing Address - Fax:870-535-3558
Practice Address - Street 1:1801 W 40TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-6961
Practice Address - Country:US
Practice Address - Phone:870-535-4850
Practice Address - Fax:870-535-3558
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR162213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARU21697Medicare UPIN
AR5T328Medicare ID - Type Unspecified