Provider Demographics
NPI:1255663233
Name:WINSTON S THOMAS, MD, PC
Entity Type:Organization
Organization Name:WINSTON S THOMAS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-266-1556
Mailing Address - Street 1:3033 N CENTRAL AVE
Mailing Address - Street 2:STE 610
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2809
Mailing Address - Country:US
Mailing Address - Phone:602-266-1556
Mailing Address - Fax:602-279-5333
Practice Address - Street 1:3033 N CENTRAL AVE
Practice Address - Street 2:STE 610
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2809
Practice Address - Country:US
Practice Address - Phone:602-266-1556
Practice Address - Fax:602-279-5333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD192002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty