Healthcare Provider Details

I. General information

NPI: 1033303367
Provider Name (Legal Business Name): CARLA N. THOMAS, MD & LINDA DUBOIS, CRNP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E 8TH ST
ANNISTON AL
36207-5730
US

IV. Provider business mailing address

216 E 8TH ST
ANNISTON AL
36207-5730
US

V. Phone/Fax

Practice location:
  • Phone: 256-237-0215
  • Fax: 256-237-0295
Mailing address:
  • Phone: 256-237-0215
  • Fax: 256-237-0295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1082088
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number11263
License Number StateAL

VIII. Authorized Official

Name: CARLA NEWBERN THOMAS
Title or Position: OWNER
Credential: M.D.
Phone: 256-237-0215