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General NPI Number Information
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NPI Number | 1437357647
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Entity Type | Organization
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Legal Business Name | CORWIN ASHFORD GORDON THOMAS PC, INC
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 802 E FARREL RD
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City | LAFAYETTE
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State | LA
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Zip | 70508-7208
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Country | US
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Telephone | 337-234-3163
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Fax | 337-234-3168
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Provider Business Mailing Address
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Address Line | 802 E FARREL RD
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City | LAFAYETTE
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State | LA
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Zip | 70508-7208
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Country | US
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Telephone | 337-234-3163
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Fax | 337-234-3168
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CROWIN A THOMAS
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Credential | DO
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Telephone | 337-234-3163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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