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NPI Code Detail

MEDICARE: RICHARD CHARLES THOMASON JR. MD

MEDICARE: RICHARD CHARLES THOMASON JR. MD
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
1208VP0000XPain Medicine Physician27733AL

General Provider Information

NPI Number : 1396951596
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CHARLES THOMASON JR. MD
Provider Business Mailing Address
First Line : PO BOX 934585
Second Line :
City : ATLANTA
State : GA
Zip : 31193-0001
Country : US
Telephone Number : 800-897-6169
Fax Number : 800-897-6170
Provider Business Practice Location Address
First Line : 1050 RUBY TYLER PKWY
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35404-2958
Country : US
Telephone Number : 205-759-7246
Fax Number : 205-759-7348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 08/16/2007

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