Healthcare Provider Details

I. General information

NPI: 1205825155
Provider Name (Legal Business Name): JAMES MCNEIL THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 QUIET CV
FAYETTEVILLE NC
28304-3857
US

IV. Provider business mailing address

PO BOX 64367
FAYETTEVILLE NC
28306-0367
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-2626
  • Fax: 910-483-6376
Mailing address:
  • Phone: 910-323-2626
  • Fax: 910-483-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number32587
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: