Individual
PHILIP K. THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4428 SUGARTREE DR E, LAKELAND, FL 33813-1861
(863) 644-2704
Mailing address
4428 SUGARTREE DR E, LAKELAND, FL 33813-1861
(863) 644-2704
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME29153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03530
BCBS OF FLORIDA
FL
01
—
1497748743
GROUP NPI / LRHSI
—
05
—
272077900
—
FL
01
—
DA5786
RAILROAD MEDICARE GROUP NUMBER
FL
Enumeration date
09/23/2005
Last updated
12/03/2012
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