MEDICARE: CYNTHIA LOUISE THOMAS PA-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	363A00000X	Physician Assistant	2764	AZ

General Provider Information

NPI Number	:	1972798866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA LOUISE THOMAS PA-C

Provider Business Mailing Address
First Line	:	287 E HUNT HWY
Second Line	:	SUITE 105
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-5095
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-677-8283

Provider Business Practice Location Address
First Line	:	287 E HUNT HWY
Second Line	:	SUITE 105
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85143-5095
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-677-8283

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

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	04/29/2017

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