Provider Demographics
NPI:1043227887
Name:THOMAS, LOVICK PIERCE VI (MD)
Entity Type:Individual
Prefix:MR
First Name:LOVICK
Middle Name:PIERCE
Last Name:THOMAS
Suffix:VI
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 LAMY LANE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-387-3453
Mailing Address - Fax:318-323-9045
Practice Address - Street 1:1601 LAMY LANE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-387-3453
Practice Address - Fax:318-323-9045
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0206872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1628492Medicaid
LA1628492Medicaid
LA4J708CD03Medicare ID - Type Unspecified