MEDICARE: DR. ERIC L THOMAS M.D.

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	208600000X	Surgery Physician	0101058099	VA
2	208600000X	Surgery Physician	41166	AZ

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	:	1073584470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC L THOMAS M.D.

Provider Business Mailing Address
First Line	:	2525 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-7935
Country	:	US
Telephone Number	:	602-470-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	14155 N 83RD AVE STE A105
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85381-5640
Country	:	US
Telephone Number	:	623-486-7700
Fax Number	:	623-486-7703

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/06/2019

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