Provider Demographics
NPI:1265456917
Name:THOMAS MEDICAL GROUP, APMC
Entity Type:Organization
Organization Name:THOMAS MEDICAL GROUP, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-352-5650
Mailing Address - Street 1:740 KEYSER AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6037
Mailing Address - Country:US
Mailing Address - Phone:318-352-5650
Mailing Address - Fax:
Practice Address - Street 1:740 KEYSER AVE
Practice Address - Street 2:SUITE F
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6037
Practice Address - Country:US
Practice Address - Phone:318-352-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05-800073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5B827Medicare ID - Type Unspecified