Individual
PROF. THOMAS AARON DEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1725 PINE ST, MONTGOMERY, AL 36106-1109
(334) 293-8000
Mailing address
102 TOMAHAWK CIR, PELHAM, AL 35124-1600
(205) 475-2002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
703720
TX
363LF0000X
Family Nurse Practitioner
Primary
1-073507
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191852601
—
TX
05
—
191852602
—
TX
Enumeration date
10/25/2006
Last updated
03/04/2016
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