Individual
MELISSA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
870 TAYLORSVILLE ROAD, TAYLORSVILLE, KY 40071
(502) 477-8888
(502) 477-2300
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(502) 489-5730
(502) 489-5753
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1072
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100028120
—
KY
Enumeration date
10/01/2007
Last updated
12/03/2020
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