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NPI Code Detail

MEDICARE: JONATHAN WILLIAM THOMA MD

MEDICARE: JONATHAN WILLIAM THOMA 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
1207Q00000XFamily Medicine Physician2018028929MO

General Provider Information

NPI Number : 1871090142
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN WILLIAM THOMA MD
Provider Business Mailing Address
First Line : PSC 78 BOX 6739
Second Line :
City : APO
State : AP
Zip : 96326-0068
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4410 REGENT ST
Second Line :
City : MADISON
State : WI
Zip : 53705-4901
Country : US
Telephone Number : 608-233-9746
Fax Number : 608-233-0026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2018
Last Update Date : 12/08/2025

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