Provider Demographics
NPI:1801492939
Name:THOMAS, ERIC LAMAR
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LAMAR
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11712 JEFFERSON AVE STE C-121
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4406
Mailing Address - Country:US
Mailing Address - Phone:757-524-3265
Mailing Address - Fax:
Practice Address - Street 1:700 TECH CENTER PKWY STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3075
Practice Address - Country:US
Practice Address - Phone:757-524-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver