Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 542 | NC |
NPI | 1043456445 |
---|---|
Provider Name | Dr. Jeremy Michael Thomas |
First Address | Southern Pines, NC 28387 |
Second Address | Southern Pines, NC 28387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2009 |
Last Update Date | 18/12/2020 |