Provider Demographics
NPI:1891979829
Name:DUCOMBS, THOMAS VICTOR (AUD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:VICTOR
Last Name:DUCOMBS
Suffix:
Gender:M
Credentials:AUD
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 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:561-478-8770
Mailing Address - Fax:561-688-8877
Practice Address - Street 1:114 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4849
Practice Address - Country:US
Practice Address - Phone:704-296-0801
Practice Address - Fax:704-289-8971
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6275231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412882Medicaid
NC7412882Medicaid