Healthcare Provider Details

I. General information

NPI: 1124968136
Provider Name (Legal Business Name): AUSTIN DUNCAN THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 W 1ST ST
WINSTON SALEM NC
27104-4220
US

IV. Provider business mailing address

3223 JENA ST
NEW ORLEANS LA
70125-5019
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4479
  • Fax:
Mailing address:
  • Phone: 704-960-3264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: