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NPI Code Detail

MEDICARE: DR. JEFFREY BERNARD THOMAS M.D.

MEDICARE: DR. JEFFREY BERNARD 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
1208600000XSurgery Physician29435SC
2208600000XSurgery Physician34540TN

General Provider Information

NPI Number : 1780679241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY BERNARD THOMAS M.D.
Provider Business Mailing Address
First Line : 111 TIFTON DR E
Second Line :
City : GREENWOOD
State : SC
Zip : 29649-3207
Country : US
Telephone Number : 864-223-8090
Fax Number :
Provider Business Practice Location Address
First Line : 160 ACADEMY AVE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-3808
Country : US
Telephone Number : 864-223-8090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 01/25/2022

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