Provider Demographics
NPI:1114029931
Name:THOMAS, CARL FILMORE III (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:FILMORE
Last Name:THOMAS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # MCM-14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5264
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:1525 LOS ALTOS PKWY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-6692
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-3900
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2020-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG8460207Q00000X
AKAA2558207Q00000X
NV20013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2558Medicaid
AKMD2558Medicaid
AKC22595Medicare UPIN