Provider Demographics
NPI:1154384212
Name:THOMAS, JASON JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:JOSEPH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-1385
Mailing Address - Country:US
Mailing Address - Phone:252-209-3708
Mailing Address - Fax:252-209-3709
Practice Address - Street 1:500 ACADEMY ST S
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3248
Practice Address - Country:US
Practice Address - Phone:252-209-3708
Practice Address - Fax:252-209-3709
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC187401OtherMEDCOST
NC1407NOtherBCBS
NCPIN P00349757OtherRR MEDICARE
NC5902570Medicaid
NC1407NOtherBCBS
NCPIN P00349757OtherRR MEDICARE