Provider Demographics
NPI:1386869931
Name:THOMAS, ANTHONY
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 PEGRAM LN
Mailing Address - Street 2:A BUILDING
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-2414
Mailing Address - Country:US
Mailing Address - Phone:540-834-0101
Mailing Address - Fax:540-834-2171
Practice Address - Street 1:114 PEGRAM LN
Practice Address - Street 2:A BUILDING
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2414
Practice Address - Country:US
Practice Address - Phone:540-834-0101
Practice Address - Fax:540-834-2171
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)