Individual
JOHN C THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
115 E 19TH ST, ROSWELL, NM 88201-5151
(575) 622-7600
(575) 622-3856
Mailing address
115 E 19TH ST, ROSWELL, NM 88201-5151
(575) 622-7600
(575) 622-3856
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
96-PA07
NM
363A00000X
Physician Assistant
96-PA07
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000J116
—
NM
Enumeration date
05/18/2006
Last updated
03/02/2011
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