Provider Demographics
NPI:1144298845
Name:CHEYNE, THOMAS E (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:CHEYNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11230
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1230
Mailing Address - Country:US
Mailing Address - Phone:479-709-6700
Mailing Address - Fax:479-709-6751
Practice Address - Street 1:3501 WE KNIGHT DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6248
Practice Address - Country:US
Practice Address - Phone:479-709-6700
Practice Address - Fax:479-709-6751
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5734207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100076850AOtherOKLAHOMA MEDICAID
AR0464691OtherCIGNA
AR200038811OtherRAILROAD MEDICAE
AR0920084OtherUNITED HEALTHCARE
AR101905001Medicaid
AR17637000000OtherQUALCHOICE
AR904221OtherUSA MCO
AR4613344OtherAETNA
AR50998OtherARKANSAS BLUE CROSS
AR0464691OtherCIGNA
ARC67998Medicare UPIN