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General NPI Number Information
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NPI Number | 1336256486
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Entity Type | Individual
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Provider Name | THALES N PAVLATOS MD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 100 W MAIN ST
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City | SPRINGFIELD
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State | OH
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Zip | 45502-1312
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Country | US
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Telephone | 937-521-3900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 632621
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City | CINCINNATI
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State | OH
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Zip | 45263-2621
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Country | US
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Telephone | 706-650-0705
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Fax | 706-650-1034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35051485P
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35051485
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License Number State | OH
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