Provider Demographics
NPI:1063162659
Name:WESTFALL, THOMAS LUTHER III (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LUTHER
Last Name:WESTFALL
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5163 SUNRISE VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9350
Mailing Address - Country:US
Mailing Address - Phone:606-359-5303
Mailing Address - Fax:
Practice Address - Street 1:401 HADDON AVE BLDG SUITE352
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1505
Practice Address - Country:US
Practice Address - Phone:856-757-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program