Provider Demographics
NPI:1740202191
Name:THOMAS, JAMES L (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE G500
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3656
Mailing Address - Country:US
Mailing Address - Phone:304-691-1262
Mailing Address - Fax:304-691-1666
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE G500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1262
Practice Address - Fax:304-691-1666
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00167213E00000X
FLPO3470213E00000X
WV10397213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA498884924AMedicaid
AL009932259Medicaid
ALT63505OtherHEALTHSPRING OF ALABAMA
AL051529534OtherBLUE CROSS
FL3406466-00Medicaid
AL480021239OtherRAILROAD MEDICARE
AL000037127Medicaid
AL000037127OtherBLUE CROSS
ALT63505OtherHEALTHSPRING OF ALABAMA
AL051529534OtherBLUE CROSS
GA498884924AMedicaid