Provider Demographics
NPI:1972614345
Name:ASSOCIATES PHYSICAL THERAPY AND PAIN MANAGEMENT
Entity type:Organization
Organization Name:ASSOCIATES PHYSICAL THERAPY AND PAIN MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMLISON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, OCS
Authorized Official - Phone:501-687-0851
Mailing Address - Street 1:11900 KANIS RD
Mailing Address - Street 2:SUITE D4
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211
Mailing Address - Country:US
Mailing Address - Phone:501-687-0851
Mailing Address - Fax:501-687-0853
Practice Address - Street 1:11900 KANIS RD
Practice Address - Street 2:SUITE D4
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211
Practice Address - Country:US
Practice Address - Phone:501-687-0851
Practice Address - Fax:501-687-0853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W154OtherTHOMAS P. BATES-BLUE CROS
AR156654721Medicaid
ARP00222774OtherTHOMAS P. BATES-RAILROAD
AR150763742Medicaid
AR5V266C883OtherMARY PERSSON - MEDICARE
AR5X452OtherNATHAN TUMLISON-BLUE CROS
AR5V266OtherMARY PERSSON - BLUE CROSS BLUE SHIELD
ARP00094056OtherNATHAN TUMLISON-RAILROAD
AR156654721Medicaid
ARP00094056OtherNATHAN TUMLISON-RAILROAD