Provider Demographics
NPI:1073725875
Name:THOMAS, CHRISTIE SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIE
Middle Name:SUSAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTIE
Other - Middle Name:SUSAN
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:720 GALLATIN STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4414
Mailing Address - Country:US
Mailing Address - Phone:256-551-6510
Mailing Address - Fax:256-551-6507
Practice Address - Street 1:720 GALLATIN STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4414
Practice Address - Country:US
Practice Address - Phone:256-551-6510
Practice Address - Fax:256-551-6507
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD038082207RR0500X
ALMD.32476207R00000X
AL32476207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL149494Medicaid
AL149494Medicaid