Individual
MR. MARK DAVID THOMAS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-5743
Mailing address
4800 PALO DURO AVE NE, ALBUQUERQUE, NM 87110-1112
(505) 888-4596
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
501 VETPRO
NM
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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