Basic Information
Provider Information
NPI: 1801923032
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMAS
FirstName: FRANK
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22 WALNUT ST
Address2: LHC ADMINISTRATION
City: WELLSBORO
State: PA
PostalCode: 169011526
CountryCode: US
TelephoneNumber: 5707230621
FaxNumber:  
Practice Location
Address1: 6 RIVERSIDE PLZ
Address2:  
City: BLOSSBURG
State: PA
PostalCode: 169121137
CountryCode: US
TelephoneNumber: 5706382174
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 08/21/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD010371EPAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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