Provider Demographics
NPI:1558377341
Name:THORNE MEDICAL SERVICES, LTD
Entity type:Organization
Organization Name:THORNE MEDICAL SERVICES, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:273-773-2218
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348-0766
Mailing Address - Country:US
Mailing Address - Phone:276-773-2218
Mailing Address - Fax:276-773-2815
Practice Address - Street 1:139 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348-0766
Practice Address - Country:US
Practice Address - Phone:276-773-2218
Practice Address - Fax:276-773-2815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102032808208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890643CMedicaid
VA217072OtherANTHEM BC/BS VA
NC890643CMedicaid
VA01001426Medicare ID - Type Unspecified