MEDICARE: DR. RANDALL CLYDE THOMAS JR. D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	36.003703	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013201417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDALL CLYDE THOMAS JR. D.P.M.

Provider Business Mailing Address
First Line	:	6480 HARRISON AVE STE 201
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-7961
Country	:	US
Telephone Number	:	513-713-1779
Fax Number	:	513-854-9921

Provider Business Practice Location Address
First Line	:	3695 N HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3520
Country	:	US
Telephone Number	:	614-267-8387
Fax Number	:	614-267-2250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2011
Last Update Date	:	11/08/2023

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