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General NPI Number Information
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NPI Number | 1578573382
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Entity Type | Individual
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Provider Name | JENNIFER THOMAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 4202 W. OAKWOOD PARK CT. STE 200
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City | FRANKLIN
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State | WI
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Zip | 53132-9565
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Country | US
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Telephone | 414-423-5250
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Fax | 414-423-5256
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Provider Business Mailing Address
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Address Line | 100 15TH AVE #180
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-1160
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Country | US
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Telephone | 414-768-5430
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Fax | 414-762-4225
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35632
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License Number State | WI
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