Provider Demographics
NPI:1558658591
Name:EARNEST, THOMAS E JR (DOM)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:EARNEST
Suffix:JR
Gender:M
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4808 MESA PRIETA CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-4620
Mailing Address - Country:US
Mailing Address - Phone:505-899-2949
Mailing Address - Fax:
Practice Address - Street 1:4808 MESA PRIETA CT NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-4620
Practice Address - Country:US
Practice Address - Phone:505-899-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM932171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist