Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36.003703 | OH |
NPI | 1013201417 |
---|---|
Provider Name | Dr. Randall Clyde Thomas JR. |
First Address | Columbus, OH 43214-3520 |
Second Address | Columbus, OH 43214-3520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2011 |
Last Update Date | 24/07/2014 |