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Individual

DR. RICHARD SCOTT THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
(208) 398-2120
Mailing address
4664 N PENNGROVE WAY STE 100, MERIDIAN, ID 83646-7442
(208) 898-7467
(208) 398-2120

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
DO163719
OR
207N00000X
Dermatology Physician
Primary
O-0934
ID
207ND0101X
MOHS-Micrographic Surgery Physician
O0934
ID
208D00000X
General Practice Physician
O0934
ID

Other

Enumeration date
06/20/2012
Last updated
10/01/2020
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