Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 019485 | LA |
NPI | 1205836558 |
---|---|
Provider Name | Dr. David E Thomas |
First Address | Baton Rouge, LA 70809-1443 |
Second Address | Baton Rouge, LA 70809-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 29/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1569046 | (05) | LA |
H23032 | (02) | LA |