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General NPI Number Information
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NPI Number | 1548655822
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Entity Type | Organization
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Legal Business Name | RONALD G THOMAS MD LLC
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 1310 ALEXANDER DR
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City | GUILFORD
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State | CT
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Zip | 06437-5031
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Country | US
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Telephone | 203-203-5189
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 ALEXANDER DR
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City | GUILFORD
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State | CT
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Zip | 06437-5031
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Country | US
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Telephone | 203-203-5189
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Fax | 203-452-7792
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Authorized Official
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Title or Position | OWNER
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Name | RONALD G THOMAS
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Credential | MD
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Telephone | 203-203-5189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 031500
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License Number State | CT
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