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General NPI Number Information
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NPI Number | 1457537540
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Entity Type | Organization
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Legal Business Name | CLIFTON E. THOMAS, MD, PA
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 3460 NE STALLINGS DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-8719
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Country | US
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Telephone | 936-569-1889
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Fax |
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Provider Business Mailing Address
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Address Line | 3460 NE STALLINGS DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-8719
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Country | US
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Telephone | 936-569-1889
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | CLIFTON EDWIN THOMAS
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Credential | MD
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Telephone | 936-569-1889
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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 | H8861
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License Number State | TX
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