Organization
JACKSONVILLE FAMILY MEDICAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY A THOMAS M.D. (PHYSICIAN)
(910) 938-3200
Entity
Organization
Contact information
Practice address
2587 HENDERSON DR, JACKSONVILLE, NC 28546-5253
(910) 938-3200
(910) 938-3043
Mailing address
2587 HENDERSON DR, JACKSONVILLE, NC 28546-5253
(910) 938-3200
(910) 938-3043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011JH
—
NC
01
—
DG9898
RAILROAD MEDICARE PIN
NC
Enumeration date
09/21/2006
Last updated
05/09/2008
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