Provider Demographics
NPI:1972798866
Name:THOMAS, CYNTHIA LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:287 E HUNT HWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5095
Mailing Address - Country:US
Mailing Address - Phone:480-677-8282
Mailing Address - Fax:480-677-8283
Practice Address - Street 1:287 E HUNT HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5095
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:480-677-8283
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2017-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ2764363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant