Organization
KEN THOMAS MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN L THOMAS M.D. (OWNER)
(337) 527-2491
Entity
Organization
Contact information
Practice address
622 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-2491
(337) 528-2749
Mailing address
622 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-2491
(337) 528-2749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200106
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4394993420
BLUE CROSS OF LOUISIANA
LA
Enumeration date
12/21/2006
Last updated
02/14/2008
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