MEDICARE: DR JOHN E THOMASSY P C

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	111N00000X	Chiropractor	0104000206	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2237537-00	OTHER	VA	U.S. DEPT. OF LABOR
2	244733	OTHER	VA	BLUE CROSS/BLUE SHIELD #

General Provider Information

NPI Number	:	1548233950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JOHN E THOMASSY P C

Provider Business Mailing Address
First Line	:	4136 BONNEY ROAD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1741
Country	:	US
Telephone Number	:	757-340-2817
Fax Number	:	757-340-4866

Provider Business Practice Location Address
First Line	:	4136 BONNEY ROAD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1741
Country	:	US
Telephone Number	:	757-340-2817
Fax Number	:	757-340-4866

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN EDWARD THOMASSY
Credential	:	D.C.
Telephone Number	:	757-340-2817

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	08/31/2010

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Directions to “DR JOHN E THOMASSY P C ” Practice Location

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