Individual
DR. IGNATIUS THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1051 GAUSE BLVD, SUITE 320, SLIDELL, LA 70458-2951
(985) 726-2655
(985) 643-9808
Mailing address
1051 GAUSE BLVD, SUITE 320, SLIDELL, LA 70458-2951
(985) 726-2655
(985) 643-9808
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
11618
MS
207RC0000X
Cardiovascular Disease Physician
Primary
14027
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017357
—
MS
01
—
060018916
RAILROAD MEDICARE
—
05
—
1173690
—
LA
01
—
188649128D
BLUE CROSS BLUE SHIELD
LA
Enumeration date
05/31/2005
Last updated
08/25/2011
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