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1689057721 NPI number — JOHN THAMES D.O.

NPI Number: 1689057721
Health Care Provider/Practitioner: JOHN THAMES D.O.

Information about “1689057721” NPI (JOHN THAMES D.O.) exists in 1689057721 in HTML format HTML  |  1689057721 in plain Text format TXT  |  1689057721 in PDF (Portable Document Format) PDF  |  1689057721 in an XML format XML  formats.

NPI Number : 1689057721 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689057721",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THAMES",
    "FirstName": "JOHN",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1428 AZALEA DR S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WIGGINS",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39577-8195",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-928-9674",
    "MailingAddressFaxNumber": "601-928-5963",
    "FirstLinePracticeLocationAddress": "1428 AZALEA DR S",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WIGGINS",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39577",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-928-9674",
    "PracticeLocationAddressFaxNumber": "601-928-5963",
    "EnumerationDate": "07/07/2015",
    "LastUpdateDate": "06/22/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207P00000X",
          "TaxonomyName": "Emergency Medicine Physician",
          "LicenseNumber": "24548",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "24548",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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