Provider Demographics
NPI:1720304389
Name:THORNTON, THOMAS J (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:THORNTON
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:311 LONG RAPIDS PLZ
Mailing Address - Street 2:P.O. BOX 535
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1375
Mailing Address - Country:US
Mailing Address - Phone:989-354-5717
Mailing Address - Fax:989-356-6526
Practice Address - Street 1:311 LONG RAPIDS PLZ
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1375
Practice Address - Country:US
Practice Address - Phone:989-354-5717
Practice Address - Fax:989-356-6526
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2015-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301096689208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery