MEDICARE: MR. PATRICK K THORNTON SA-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	246ZC0007X	Surgical Assistant	08-106	VA

General Provider Information

NPI Number	:	1962670869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK K THORNTON SA-C

Provider Business Mailing Address
First Line	:	1506 KING CHARLES CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23236-1905
Country	:	US
Telephone Number	:	804-320-0866
Fax Number	:

Provider Business Practice Location Address
First Line	:	1506 KING CHARLES CT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23236-1905
Country	:	US
Telephone Number	:	804-320-0866
Fax Number	:

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

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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