Provider Demographics
NPI:1942936166
Name:THOMAS, BECKY JO (MD)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:JO
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BECKY
Other - Middle Name:JO
Other - Last Name:LAGGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45422-1280
Mailing Address - Country:US
Mailing Address - Phone:937-496-7190
Mailing Address - Fax:937-496-3070
Practice Address - Street 1:117 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45422-1280
Practice Address - Country:US
Practice Address - Phone:937-496-7190
Practice Address - Fax:937-496-3070
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.073102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine