Provider Demographics
NPI:1598940231
Name:GARRY J THOMAS MD PC DBA
Entity Type:Organization
Organization Name:GARRY J THOMAS MD PC DBA
Other - Org Name:THOMAS RETINAL EYE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-272-1644
Mailing Address - Street 1:2500 DEKALB PK
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401
Mailing Address - Country:US
Mailing Address - Phone:910-272-1644
Mailing Address - Fax:610-272-3210
Practice Address - Street 1:2045 WESTGATE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-272-1644
Practice Address - Fax:610-272-3210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-038774-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA507539Medicare PIN
507539Medicare PIN
E53919Medicare UPIN