Healthcare Provider Details

I. General information

NPI: 1154315059
Provider Name (Legal Business Name): LINDA J THOMAS-HEMAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 S WASHINGTON AVE
JERMYN PA
18433-1121
US

IV. Provider business mailing address

5 S WASHINGTON AVE
JERMYN PA
18433-1121
US

V. Phone/Fax

Practice location:
  • Phone: 570-383-9934
  • Fax: 570-383-6258
Mailing address:
  • Phone: 570-383-9934
  • Fax: 570-383-6258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD065507L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberMD065507L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD065507L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberMD065507L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: