Provider Demographics
NPI:1245271568
Name:THOMAS, JOSEPH MARTIN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MARTIN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5442 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2602
Mailing Address - Country:US
Mailing Address - Phone:814-833-7246
Mailing Address - Fax:814-833-1147
Practice Address - Street 1:5442 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2602
Practice Address - Country:US
Practice Address - Phone:814-833-7246
Practice Address - Fax:814-833-1147
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045797L208VP0000X
PAMD045767L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA273480OtherHIGHMARK BLUE SHIELD
GA050018093OtherRAILROAD MEDICARE
OH0717424Medicaid
PA75169OtherUNISON/MEDPLUS
PA0012660260005Medicaid
GA050018093OtherRAILROAD MEDICARE
PA273480OtherHIGHMARK BLUE SHIELD
PA090452Medicare ID - Type Unspecified