Provider Demographics
NPI:1275768855
Name:THOMAS, JOANNA B (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:B
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1971 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 1895
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24515-0002
Mailing Address - Country:US
Mailing Address - Phone:434-200-6370
Mailing Address - Fax:434-455-0966
Practice Address - Street 1:1971 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 1895
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24515-0002
Practice Address - Country:US
Practice Address - Phone:434-200-6370
Practice Address - Fax:434-455-0966
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101254247207Q00000X
IN01069010A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00910753OtherRAILROAD MEDICARE
IN201015360AMedicaid
IN201015360AMedicaid