Provider Demographics
NPI:1780770842
Name:THOMAS, PAUL C (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-626-6161
Mailing Address - Fax:419-502-3511
Practice Address - Street 1:26151 EUCLID AVE
Practice Address - Street 2:STE 201
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3300
Practice Address - Country:US
Practice Address - Phone:216-261-7970
Practice Address - Fax:216-261-6191
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2019256Medicaid
OHG54123Medicare UPIN
OH9913901Medicare PIN