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General NPI Number Information
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NPI Number | 1710943485
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Entity Type | Individual
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Provider Name | JOHN WALTER THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 8501 OLD TROY PIKE STE 120
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-1061
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Country | US
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Telephone | 937-237-4945
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Fax | 937-237-4925
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Provider Business Mailing Address
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Address Line | PO BOX 933432
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City | CLEVELAND
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State | OH
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Zip | 44193-0039
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Country | US
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Telephone | 937-641-5072
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Fax | 937-641-6129
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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 | 35073991
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License Number State | OH
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