Individual
ALLAN RAY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Mailing address
1320 W MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004423
OH
363AM0700X
Medical Physician Assistant
1098226
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160639
—
OH
Enumeration date
06/24/2011
Last updated
05/14/2018
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