Basic Information
| Provider Information | |||||||||
| NPI: | 1629377098 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | JAMES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 295 S CHIPETA WAY | ||||||||
| Address2: | |||||||||
| City: | SLC | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841081287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015814178 | ||||||||
| FaxNumber: | 8015877417 | ||||||||
| Practice Location | |||||||||
| Address1: | 295 S CHIPETA WAY | ||||||||
| Address2: | |||||||||
| City: | SLC | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841081287 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015814178 | ||||||||
| FaxNumber: | 8015877417 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2011 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 10289987 | UT | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.