Doctor Name: | DR. JAMES LEROY THOMSON |
NPI Number: | 1508850884 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A21783 |
Business Practice Address: | 1212 Farmers Ln Santa Rosa, CA - 954056747 |
Business Phone Number: | 7075468918 |
Business Fax Number: | 7075468919 |
Mailing Address: | 1212 Farmers Ln, SANTA ROSA |
State: | CA |
Postal Code: | 954056747 |
Phone Number: | 7075468918 |
Fax Number: | 7075468919 |
NPI Enumeration Date: | 09/01/2005 |
NPI Last Update Date: | 09/28/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A21783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |