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General NPI Number Information
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NPI Number | 1427290360
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Entity Type | Individual
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Provider Name | BENJAMIN JOHN THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 8786 PERIMETER PARK BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6347
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Country | US
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Telephone | 904-997-9202
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Fax | 904-997-9205
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Provider Business Mailing Address
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Address Line | 8786 PERIMETER PARK BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-6347
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Country | US
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Telephone | 904-997-9202
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Fax | 904-996-1446
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 75932
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | ME127512
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 75932
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME127512
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License Number State | FL
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