Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 27872 | AL |
Y | 2081P2900X | Pain Medicine | 27872 | AL |
NPI | 1134339799 |
---|---|
Provider Name | Robert Ty Thomas |
First Address | Vestavia, AL 35243-2502 |
Second Address | Vestavia, AL 35243-2502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 28/01/2020 |