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General NPI Number Information
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NPI Number | 1730186883
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Entity Type | Individual
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Provider Name | DENNIS THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 1850 POCAHONTAS TRL
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City | QUINTON
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State | VA
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Zip | 23141-1657
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Country | US
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Telephone | 804-932-4388
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Fax | 804-932-9860
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Provider Business Mailing Address
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Address Line | 4630 S LABURNUM AVE STE B
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City | RICHMOND
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State | VA
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Zip | 23231-2441
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Country | US
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Telephone | 804-932-4388
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Fax | 804-932-9860
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101032309
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License Number State | VA
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