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General NPI Number Information
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NPI Number | 1245409002
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Entity Type | Organization
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Legal Business Name | MICHAEL THOMAS MD PC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 5651 FRIST BLVD SUITE 709
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City | HERMITAGE
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State | TN
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Zip | 37076-2054
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Country | US
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Telephone | 615-871-4904
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Fax | 615-871-9682
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Provider Business Mailing Address
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Address Line | 5651 FRIST BLVD SUITE 709
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City | HERMITAGE
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State | TN
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Zip | 37076-2054
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Country | US
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Telephone | 615-871-4904
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Fax | 615-871-9682
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL C THOMAS
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Credential | M.D.
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Telephone | 615-871-4904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 13976MD
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License Number State | TN
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