Provider Demographics
NPI:1770599904
Name:RATH, THOMAS KURT (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:KURT
Last Name:RATH
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 1:900 E FLORENCE BLVD
Mailing Address - Street 2:SUITE H AND I
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85222-4666
Mailing Address - Country:US
Mailing Address - Phone:520-836-2536
Mailing Address - Fax:
Practice Address - Street 1:900 E FLORENCE BLVD
Practice Address - Street 2:SUITE H AND I
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-4666
Practice Address - Country:US
Practice Address - Phone:520-836-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM92-332207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine