Provider Demographics
NPI:1568248227
Name:DR J THOMAS DO MBA FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:DR J THOMAS DO MBA FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-335-2672
Mailing Address - Street 1:655 HERSHEY RD
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-9243
Mailing Address - Country:US
Mailing Address - Phone:717-566-3796
Mailing Address - Fax:717-566-0576
Practice Address - Street 1:655 HERSHEY RD
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-9243
Practice Address - Country:US
Practice Address - Phone:717-566-3796
Practice Address - Fax:717-566-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS019840OtherSTATE BOARD OF OSTEOPATHIC MEDICINE
PA26564268OtherPENNSYLVANIA BMV