Provider Demographics
NPI:1164845038
Name:THOMAS INTERNAL MEDICINE, P.A.
Entity Type:Organization
Organization Name:THOMAS INTERNAL MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-236-2525
Mailing Address - Street 1:11512 E HIGHWAY 316
Mailing Address - Street 2:
Mailing Address - City:FORT MC COY
Mailing Address - State:FL
Mailing Address - Zip Code:32134-8134
Mailing Address - Country:US
Mailing Address - Phone:352-236-2525
Mailing Address - Fax:352-236-8610
Practice Address - Street 1:15035 NE HWY 315
Practice Address - Street 2:
Practice Address - City:FORT MC COY
Practice Address - State:FL
Practice Address - Zip Code:32134
Practice Address - Country:US
Practice Address - Phone:352-236-2525
Practice Address - Fax:352-236-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty