Provider Demographics
NPI:1619230711
Name:THRASHER, TABITHA LUCYNDA (D,O)
Entity Type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:LUCYNDA
Last Name:THRASHER
Suffix:
Gender:F
Credentials:D,O
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:LUCYNDA
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 E A ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2217
Mailing Address - Country:US
Mailing Address - Phone:307-234-6161
Mailing Address - Fax:307-234-7032
Practice Address - Street 1:1522 E A ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2217
Practice Address - Country:US
Practice Address - Phone:307-234-6161
Practice Address - Fax:307-234-7032
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9713A207Q00000X
ORDO172351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine