Organization
JERRY A.THOMAS M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA DOKKA KNIGHT (PRACTICE ADMINISTRATOR)
(985) 795-4147
Entity
Organization
Contact information
Practice address
51704 HIGHWAY 438, FRANKLINTON, LA 70438
(985) 848-9955
(985) 848-9964
Mailing address
51704 HIGHWAY 438, FRANKLINTON, LA 70438
(985) 848-9955
(985) 848-9964
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD.015223
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1321044
—
LA
01
—
5DX93
MEDICARE PTAN
LA
Enumeration date
04/26/2012
Last updated
01/31/2020
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