Provider Demographics
NPI:1962445460
Name:THOMAS, ROBERT DONALD (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DONALD
Last Name:THOMAS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37530 TERRELL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-8779
Mailing Address - Country:US
Mailing Address - Phone:440-353-9856
Mailing Address - Fax:
Practice Address - Street 1:145 W WALLACE ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1239
Practice Address - Country:US
Practice Address - Phone:419-423-5262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-095420 NA-01583367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0723917Medicaid