MEDICARE: DR. TIMOTHY KIOKO 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	3407	AK

General Provider Information

NPI Number	:	1902122526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY KIOKO THOMAS M.D.

Provider Business Mailing Address
First Line	:	4055 TUDOR CENTRE DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5932
Country	:	US
Telephone Number	:	907-729-3400
Fax Number	:	907-729-3429

Provider Business Practice Location Address
First Line	:	3900 AMBASSADOR DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5922
Country	:	US
Telephone Number	:	907-729-3095
Fax Number	:	907-729-3652

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

Provider Enumeration Date	:	04/08/2010
Last Update Date	:	02/07/2020

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