Individual
DERRON T THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7569 E INDUSTRIAL DR, BATON ROUGE, LA 70805-7518
(225) 924-9164
(225) 924-5479
Mailing address
PO BOX 45698, BATON ROUGE, LA 70895-4698
(225) 924-9164
(225) 924-5479
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Enumeration date
08/04/2018
Last updated
08/04/2018
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