Provider Demographics
NPI:1912258609
Name:THOMAS, H STEPHENS (MD)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:STEPHENS
Last Name:THOMAS
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 1:344 W GARDENIA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-8719
Mailing Address - Country:US
Mailing Address - Phone:602-997-8332
Mailing Address - Fax:602-944-0900
Practice Address - Street 1:344 W GARDENIA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-8719
Practice Address - Country:US
Practice Address - Phone:602-997-8332
Practice Address - Fax:602-944-0900
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist