MEDICARE: WAYNE ERIC 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
1	207Q00000X	Family Medicine Physician	00014586	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	63-1004625	OTHER		COMMERCIAL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	51019709	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1881688968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE ERIC THOMAS M.D.

Provider Business Mailing Address
First Line	:	2828 HIGHWAY 31 S
Second Line	:	SUITE 109
City	:	DECATUR
State	:	AL
Zip	:	35603-1510
Country	:	US
Telephone Number	:	256-351-1591
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 HIGHWAY 31 S
Second Line	:	SUITE 109
City	:	DECATUR
State	:	AL
Zip	:	35603-1510
Country	:	US
Telephone Number	:	256-351-1591
Fax Number	:	256-351-1596

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	01/24/2008

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Directions to “ WAYNE ERIC THOMAS M.D.” Practice Location

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