Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 14194 | SC |
N | 207RH0003X | Hematology & Oncology | 33470 | GA |
NPI | 1043218316 |
---|---|
Provider Name | Dr. Gary W Thomas |
First Address | Hilton Head Island, SC 29926-2837 |
Second Address | Hilton Head Island, SC 29926-2837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 16/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F56870 | (02) | SC |
G07329 | (05) | SC |
P00056823 | RAILROAD MEDICARE (01) | SC |