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NPI Code Detail

MEDICARE: ROBERT R THOMAS PA-C

MEDICARE:   ROBERT R THOMAS  PA-C
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
1363A00000XPhysician Assistant1586AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1205515193OTHERFED TAX ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104805597
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT R THOMAS PA-C
Provider Business Mailing Address
First Line : 4015 LAKE OTIS PKWY
Second Line : SUITE 201
City : ANCHORAGE
State : AK
Zip : 99508-5211
Country : US
Telephone Number : 907-771-3500
Fax Number : 907-771-3550
Provider Business Practice Location Address
First Line : 4015 LAKE OTIS PKWY
Second Line : SUITE 201
City : ANCHORAGE
State : AK
Zip : 99508-5211
Country : US
Telephone Number : 907-771-3500
Fax Number : 907-771-3550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 02/22/2012

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Directions to “ ROBERT R THOMAS PA-C” Practice Location

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