Individual
DR. THOMAS GEORGE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CRNP, FNP-C
Contact information
Practice address
555 W OAK ST STE 2, SHELLEY, ID 83274-1161
(240) 308-1771
Mailing address
555 W OAK ST STE 2, SHELLEY, ID 83274-1161
(240) 308-1771
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
R216085
MD
363LF0000X
Family Nurse Practitioner
Primary
R216085
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
926580503
—
MD
Enumeration date
06/10/2015
Last updated
06/12/2024
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