Provider Demographics
NPI:1821187428
Name:FEIL, THOMAS NORMAN (PAC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:NORMAN
Last Name:FEIL
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 FAIRVIEW AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3915
Mailing Address - Country:US
Mailing Address - Phone:610-923-5200
Mailing Address - Fax:610-923-5272
Practice Address - Street 1:2005 FAIRVIEW AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3915
Practice Address - Country:US
Practice Address - Phone:610-923-5200
Practice Address - Fax:610-923-5272
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.006516RX363AS0400X
PAMA001634L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0410664Medicaid
PA50067157OtherCAPITAL BLUE CROSS
PA082497R15Medicare ID - Type Unspecified
PA108597V8GMedicare PIN