MEDICARE: MICHAEL C 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
1	363A00000X	Physician Assistant	50.001864	OH
2	363AS0400X	Surgical Physician Assistant	50-00-1864	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	:	1538152947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL C THOMAS PA-C

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	:	7277 SMITHS MILL RD STE 200
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-8195
Country	:	US
Telephone Number	:	614-221-6331
Fax Number	:	614-221-9042

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	11/09/2023

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Directions to “ MICHAEL C THOMAS PA-C” Practice Location

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