Provider Demographics
NPI:1619968609
Name:THOMAS, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:89 SOUTH MAST RD
Mailing Address - Street 2:ELLIOT FAMILY MEDICINE AT GLEN LAKE
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-6102
Mailing Address - Country:US
Mailing Address - Phone:603-497-5661
Mailing Address - Fax:603-497-5740
Practice Address - Street 1:89 SOUTH MAST RD
Practice Address - Street 2:ELLIOT FAMILY MEDICINE AT GLEN LAKE
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-6102
Practice Address - Country:US
Practice Address - Phone:603-497-5661
Practice Address - Fax:603-497-5740
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH10974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1354314OtherCIGNA PIN
NH30202004Medicaid
NH712986OtherHPHC PIN
80184889OtherRR MEDICARE
NH10974OtherTUFTS PIN
NH0102484OtherUHC PIN
NH2943602OtherAETNA PIN
NHH31983OtherANTHEM REFERRING UPN
80184889OtherRR MEDICARE
NHRE6085Medicare PIN