Healthcare Provider Details

I. General information

NPI: 1326043852
Provider Name (Legal Business Name): THOMAS A BILLINGS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N STATE ST
UKIAH CA
95482
US

IV. Provider business mailing address

1050 N STATE ST
UKIAH CA
95482-3414
US

V. Phone/Fax

Practice location:
  • Phone: 707-463-7495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35050954B
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC159821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: