Individual
DR. THOMAS JOSEPH CARRICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 947-1801
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
0101032447
VA
208200000X
Plastic Surgery Physician
0101032447
VA
208600000X
Surgery Physician
0101032447
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186304
ANTHEM PROVIDER NUMBER
—
01
—
203639329006
TRICARE PROVIDER NUMBER
—
01
—
329096
SOUTHERN HEALTH PROVIDER
—
01
—
90402
SENTARA/OPTIMA PROVIDER N
—
Enumeration date
06/24/2005
Last updated
03/11/2008
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