Provider Demographics
NPI:1639265788
Name:THOMAS, JAMES R (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 714328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-4328
Mailing Address - Country:US
Mailing Address - Phone:440-354-1899
Mailing Address - Fax:440-354-1845
Practice Address - Street 1:26151 EUCLID AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3322
Practice Address - Country:US
Practice Address - Phone:216-261-7970
Practice Address - Fax:216-261-6191
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0376329Medicaid
OHH142600Medicare PIN
OHA77596Medicare UPIN