Individual
THOMAS WEEKLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6644 E BAYWOOD AVE, MESA, AZ 85206-1747
(480) 981-4391
(480) 981-4624
Mailing address
PO BOX 708850, SANDY, UT 84070-8850
(866) 869-2395
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30929
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102164
MEDICARE-TYPE UNSPECIFIED
AZ
01
—
110245891
RR MEDICARE
AZ
05
—
74090302
—
AZ
01
—
AZ0723310
BCBS
AZ
Enumeration date
03/24/2006
Last updated
10/26/2007
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