Provider Demographics
NPI:1437355120
Name:THOMAS, ROY HAMILTON (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:HAMILTON
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6559
Mailing Address - Country:US
Mailing Address - Phone:440-366-9411
Mailing Address - Fax:440-366-9403
Practice Address - Street 1:850 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6559
Practice Address - Country:US
Practice Address - Phone:440-366-9411
Practice Address - Fax:440-366-9403
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051885207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0592701Medicaid
OHA16107Medicare UPIN
TH0568712Medicare ID - Type Unspecified