Provider Demographics
NPI:1922399211
Name:WILL, THOMAS B
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:WILL
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 1:4278 ALISON AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-6160
Mailing Address - Country:US
Mailing Address - Phone:814-455-7800
Mailing Address - Fax:
Practice Address - Street 1:925 W ERIE PLZ
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4535
Practice Address - Country:US
Practice Address - Phone:814-454-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026767L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist