Gordon M Thomas, D.O.
Family Medicine in Granville, NY. Individual provider (NPI-1).
NPI number1083665582
StatusActive
Last updated in NPPESJun 8, 2021
Details
- NPI
- 1083665582
- Entity type
- Individual (NPI-1)
- Name
- Gordon M Thomas
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 12, 2006
- Certification date
- Jun 8, 2021
- Last updated
- Jun 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 140385 | NY | Yes |
Practice location
79 North StGranville Family Health Center
Granville, NY 12832-1137
Phone 518-642-0612 · Fax 518-642-0693
Mailing address
100 Park StreetGlens Falls Hospital - Credentialing
Glens Falls, NY 12801-0304
Phone 518-926-5924 · Fax 518-926-6983
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