Provider Demographics
NPI:1285692947
Name:THOMAS, ANTHONY GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:THOMAS
Suffix:
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 1:111 BREWSTER STREET
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860
Mailing Address - Country:US
Mailing Address - Phone:401-729-2700
Mailing Address - Fax:401-729-2745
Practice Address - Street 1:111 BREWSTER STREET
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860
Practice Address - Country:US
Practice Address - Phone:401-729-2700
Practice Address - Fax:401-729-2745
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00360207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9003101Medicaid
RI007059158OtherMEDICARE ID TYPE UNSPECIFIED
RI0007059158Medicare NSC
RI9003101Medicaid