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NPI Code Detail

MEDICARE: ROBERT EARL THOMAS JR. MD

MEDICARE: ROBERT EARL THOMAS 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
1174400000XSpecialist18644SC
2207ZP0102XAnatomic Pathology & Clinical Pathology Physician18644SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
299535OTHERMEDCOST

General Provider Information

NPI Number : 1467444919
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT EARL THOMAS JR. MD
Provider Business Mailing Address
First Line : PO BOX 4016
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-6016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 222 S HERLONG AVE
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-1158
Country : US
Telephone Number : 803-329-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 02/20/2012

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