Provider Demographics
NPI:1245859305
Name:THOMAS, DEVON (MD)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 WEST 8TH STREET
Mailing Address - Street 2:LRC 2ND FLOOR, DEPARTMENT OF UROLOGY
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-244-7340
Mailing Address - Fax:904-244-8280
Practice Address - Street 1:653 WEST 8TH STREET
Practice Address - Street 2:LRC 2ND FLOOR, DEPARTMENT OF UROLOGY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-7340
Practice Address - Fax:904-244-8280
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program