Provider Demographics
NPI:1780873257
Name:THOMAS, JERRY (RCP)
Entity type:Individual
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First Name:JERRY
Middle Name:
Last Name:THOMAS
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Gender:M
Credentials:RCP
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Mailing Address - Street 1:PO BOX 43160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3160
Mailing Address - Country:US
Mailing Address - Phone:520-722-3777
Mailing Address - Fax:520-296-6224
Practice Address - Street 1:4644 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1111
Practice Address - Country:US
Practice Address - Phone:520-405-0141
Practice Address - Fax:520-325-3230
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
260812269OtherTIN