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General NPI Number Information
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NPI Number | 1851388573
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Entity Type | Individual
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Provider Name | UNNI C THOMAS MD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 5742 BOOTH RD SUITE A
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City | JACKSONVILLE
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State | FL
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Zip | 32207-5982
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Country | US
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Telephone | 904-739-7779
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Fax | 904-739-7771
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Provider Business Mailing Address
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Address Line | 7015 AC SKINNER PARKWAY SUITE 1
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City | JACKSONVILLE
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State | FL
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Zip | 32256
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Country | US
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Telephone | 904-363-2113
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Fax | 904-538-3672
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME 76453
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License Number State | FL
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