MEDICARE: JAMES KEVIN THOMASON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	60894	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104088590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES KEVIN THOMASON PT

Provider Business Mailing Address
First Line	:	1603 OAK ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4022
Country	:	US
Telephone Number	:	541-345-8895
Fax Number	:	541-345-8867

Provider Business Practice Location Address
First Line	:	1603 OAK ST
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97401-4022
Country	:	US
Telephone Number	:	541-345-8895
Fax Number	:	541-345-8867

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	03/20/2017

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