Individual
GREGORY M THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5100 RIVER RD N, KEIZER, OR 97303-5371
(503) 393-2533
(503) 393-5978
Mailing address
PO BOX 20130, KEIZER, OR 97307-0130
(503) 393-2533
(503) 393-5978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13584
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283663
—
OR
01
—
R157127
MEDICARE PTAN
—
Enumeration date
06/12/2006
Last updated
05/11/2011
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