Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 14733R | LA |
NPI | 1013920362 |
---|---|
Provider Name | Dr. Corwin Ashford Thomas |
First Address | Lafayette, LA 70508-7208 |
Second Address | Lafayette, LA 70508-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 07/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H71289 | (02) | LA |