Individual
MR. JEFFORY FORD THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
K0219
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051MH
BLUE CROSS BLUE SHIELD
TX
05
—
131978001
—
AR
01
—
97654
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/11/2006
Last updated
06/21/2010
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