Provider Demographics
NPI:1710557285
Name:THOMAS, JESSICA KAYLA (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KAYLA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LINKS BLVD APT 5307
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6075
Mailing Address - Country:US
Mailing Address - Phone:334-294-6153
Mailing Address - Fax:
Practice Address - Street 1:1800 LINKS BLVD APT 5307
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-6075
Practice Address - Country:US
Practice Address - Phone:334-294-6153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5590225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist