Provider Demographics
NPI:1629457205
Name:ERIC J. THOMAS
Entity Type:Organization
Organization Name:ERIC J. THOMAS
Other - Org Name:THOMAS FOOT AND ANKLE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:229-242-9502
Mailing Address - Street 1:410 CONNELL RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1898
Mailing Address - Country:US
Mailing Address - Phone:229-242-9502
Mailing Address - Fax:229-242-1725
Practice Address - Street 1:410 CONNELL RD
Practice Address - Street 2:SUITE E
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1898
Practice Address - Country:US
Practice Address - Phone:229-242-9502
Practice Address - Fax:229-242-1725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty