Provider Demographics
NPI:1538474408
Name:JERRY THOMAS MD AND ASSOCIATES
Entity Type:Organization
Organization Name:JERRY THOMAS MD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLIACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-613-2226
Mailing Address - Street 1:800 DENOW RD
Mailing Address - Street 2:SUITE 382
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5246
Mailing Address - Country:US
Mailing Address - Phone:609-613-2226
Mailing Address - Fax:609-662-1900
Practice Address - Street 1:134-6 FRANKLIN CORNER ROAD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-5246
Practice Address - Country:US
Practice Address - Phone:609-662-1900
Practice Address - Fax:609-662-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty