Healthcare Provider Details

I. General information

NPI: 1497719587
Provider Name (Legal Business Name): HOLLY JO THOMAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 N 3RD ST FL 4
HARRISBURG PA
17110
US

IV. Provider business mailing address

2645 N 3RD ST FL 4
HARRISBURG PA
17110-2033
US

V. Phone/Fax

Practice location:
  • Phone: 717-782-4700
  • Fax: 717-782-4710
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD056871L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMD056871L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: