Healthcare Provider Details

I. General information

NPI: 1295358323
Provider Name (Legal Business Name): SEAN THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2020
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WOODBINE LANE
DANVILLE PA
17822-9800
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6700
  • Fax: 570-214-6700
Mailing address:
  • Phone: 570-271-6700
  • Fax: 570-214-6700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD481877
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: