Provider Demographics
NPI:1134392939
Name:MICHAEL L. THORNTON, D.O., P.A.
Entity type:Organization
Organization Name:MICHAEL L. THORNTON, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-477-9000
Mailing Address - Street 1:1301 E DEBBIE LN
Mailing Address - Street 2:STE 102-318
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3305
Mailing Address - Country:US
Mailing Address - Phone:817-477-9000
Mailing Address - Fax:817-887-5924
Practice Address - Street 1:1301 E DEBBIE LN
Practice Address - Street 2:STE 102-318
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3305
Practice Address - Country:US
Practice Address - Phone:817-477-9000
Practice Address - Fax:817-887-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6673208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty