Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 52365 | KY |
NPI | 1083961601 |
---|---|
Provider Name | Dr. David Brandon Thomas JR. |
First Address | Brentwood, TN 37027-5098 |
Second Address | Somerset, KY 42503-1872 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2012 |
Last Update Date | 19/09/2019 |