Provider Demographics
NPI:1831344217
Name:THOMAS, DENNIS RAYMOND (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RAYMOND
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3101 RIVIERE DU CHIEN LOOP E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-5408
Mailing Address - Country:US
Mailing Address - Phone:251-661-7216
Mailing Address - Fax:251-479-2269
Practice Address - Street 1:3101 RIVIERE DU CHIEN LOOP E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-5408
Practice Address - Country:US
Practice Address - Phone:251-661-7216
Practice Address - Fax:251-479-2269
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL16879207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC48441Medicare UPIN