Provider Demographics
NPI:1356452478
Name:STRONG, THOMAS C (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:STRONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2770 3RD AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8994
Mailing Address - Country:US
Mailing Address - Phone:337-494-4868
Mailing Address - Fax:337-494-4870
Practice Address - Street 1:2770 3RD AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-494-4868
Practice Address - Fax:337-494-4870
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAL017192208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1934747Medicaid
LA4E633C963OtherMEDICARE LEGACY
LAE04349Medicare UPIN
LA4E633C963OtherMEDICARE LEGACY