Basic Information
| Provider Information | |||||||||
| NPI: | 1275768855 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | FOSTER | ||||||||
| OtherFirstName: | JOANNA | ||||||||
| OtherMiddleName: | B | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1971 UNIVERSITY BLVD | ||||||||
| Address2: | SUITE 1895 | ||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245150002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342006370 | ||||||||
| FaxNumber: | 4344550966 | ||||||||
| Practice Location | |||||||||
| Address1: | 1971 UNIVERSITY BLVD | ||||||||
| Address2: | SUITE 1895 | ||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245150002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342006370 | ||||||||
| FaxNumber: | 4344550966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2009 | ||||||||
| LastUpdateDate: | 05/12/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101254247 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00910753 | 01 | IN | RAILROAD MEDICARE | OTHER | 201015360A | 05 | IN | MEDICAID |