MEDICARE: JULIA INETTA THORNTON MD

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	207RG0100X	Gastroenterology Physician	35086610	OH
2	207RG0100X	Gastroenterology Physician	MD00040501	WA

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	:	1891710166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA INETTA THORNTON MD

Provider Business Mailing Address
First Line	:	1001 LAKESIDE AVE E
Second Line	:	#1200
City	:	CLEVELAND
State	:	OH
Zip	:	44114-1158
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 SEVERANCE CIR
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-1502
Country	:	US
Telephone Number	:	216-524-7377
Fax Number	:	216-297-2751

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/14/2013

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Directions to “ JULIA INETTA THORNTON MD” Practice Location

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