Individual
MR. ROBERT LEE THOMAS IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 N 19TH ST, SUITE B301, MIDDLESBORO, KY 40965-2865
(606) 248-7509
Mailing address
PO BOX 340, MIDDLESBORO, KY 40965-0340
(606) 278-7509
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12835
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3028439
—
TN
05
—
64254337
—
KY
Enumeration date
08/03/2005
Last updated
04/17/2013
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