Individual
SAMUEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6165 W EMERALD ST, BOISE, ID 83704-8613
(208) 302-3900
(208) 302-3955
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2046
ID
363AS0400X
Surgical Physician Assistant
—
FL
Other
Enumeration date
06/19/2017
Last updated
07/11/2023
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