Provider Demographics
NPI:1699378752
Name:THOMAS, JAMES PERRY
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PERRY
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 WASHINGTON ST W
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1536
Mailing Address - Country:US
Mailing Address - Phone:681-217-2081
Mailing Address - Fax:
Practice Address - Street 1:5192 CRYSTAL DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-1950
Practice Address - Country:US
Practice Address - Phone:304-389-2706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator