| Organization Name: | JERRY A THOMAS M.D., LLC |
| NPI Number: | 1023376183 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERRY AROE THOMAS (OWNER) |
| Mailing Address: | 51704 Highway 438 Franklinton |
| State: | LA US |
| Postal Code: | 704387488 |
| Phone Number: | 9858489955 |
| Fax Number: | 9858489964 |
| NPI Enumeration Date: | 04/26/2012 |
| NPI Last Update Date: | 08/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD.015223 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |