1659333227 NPI number — PAUL B THOMLEY RN, MSN, APN-BC

Table of content: PAUL B THOMLEY RN, MSN, APN-BC (NPI 1659333227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659333227 NPI number — PAUL B THOMLEY RN, MSN, APN-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMLEY
Provider First Name:
PAUL
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, APN-BC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659333227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37065-1226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-591-2732
Provider Business Mailing Address Fax Number:
615-591-2779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1419 NATIONAL HWY
Provider Second Line Business Practice Location Address:
MIDWAY PLAZA
Provider Business Practice Location Address City Name:
THOMASVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27360-2319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-889-7213
Provider Business Practice Location Address Fax Number:
336-889-7216
Provider Enumeration Date:
04/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5004008 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51532904 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 3341229 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00464603 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7004126 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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