Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 9916 | TN |
NPI | 1013200054 |
---|---|
Provider Name | Dr. Ryan Fitzgerald Thomas |
First Address | Nashville, TN 37211-6540 |
Second Address | Nashville, TN 37211-6540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 17/06/2015 |