Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 30366 | TN |
NPI | 1124034301 |
---|---|
Provider Name | Dr. Lamar Brannon Thomas |
First Address | Tampa, FL 33647-2262 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |