Organization
C. THOMMEN THOMAS, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHEMPAKANALLORE THOMMEN THOMAS M.D. (PRESIDENT)
(813) 685-9693
Entity
Organization
Contact information
Practice address
165 W ROBERTSON ST, BRANDON, FL 33511-5111
(813) 685-9693
(813) 685-9774
Mailing address
165 W ROBERTSON ST, BRANDON, FL 33511-5111
(813) 685-9693
(813) 685-9774
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0042260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068619100
—
FL
Enumeration date
01/05/2011
Last updated
01/05/2011
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