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General NPI Number Information
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NPI Number | 1023376183
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Entity Type | Organization
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Legal Business Name | JERRY A.THOMAS M.D., L.L.C.
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 51704 HIGHWAY 438
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City | FRANKLINTON
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State | LA
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Zip | 70438
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Country | US
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Telephone | 985-848-9955
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Fax | 985-848-9964
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Provider Business Mailing Address
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Address Line | 51704 HIGHWAY 438
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City | FRANKLINTON
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State | LA
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Zip | 70438
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Country | US
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Telephone | 985-848-9955
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Fax | 985-848-9964
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | KRISTINA DOKKA KNIGHT
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Credential |
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Telephone | 985-795-4147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MD.015223
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License Number State | LA
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