Individual
DR. THOMAS BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4700 LAS VEGAS BLVD N, 99 MDOS/CC, NELLIS AFB, NV 89191-6600
(702) 653-2031
(702) 653-2110
Mailing address
4700 LAS VEGAS BLVD N, 99 MEDICAL OPERATIONS SQUADRON / COMMANDER, NELLIS AFB, NV 89191-6600
(702) 653-2031
(702) 653-2110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH016043
GA
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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