Provider Demographics
NPI:1700825569
Name:THOMAS, WILLIAM A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34434 KING STREET ROW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4787
Mailing Address - Country:US
Mailing Address - Phone:302-644-8880
Mailing Address - Fax:302-644-8882
Practice Address - Street 1:34434 KING STREET ROW
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4787
Practice Address - Country:US
Practice Address - Phone:302-644-8880
Practice Address - Fax:302-644-8882
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100050302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000792701Medicaid
DE0000792701Medicaid
DEG68021Medicare UPIN