Individual
KEVIN W THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5700 W GENESEE ST, STE 124, CAMILLUS, NY 13031-3200
(315) 472-8841
(315) 472-8859
Mailing address
4567 CROSSROADS PARK DR, LIVERPOOL, NY 13088-3589
(315) 295-2100
(315) 295-2125
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
166445
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01037663
—
NY
Enumeration date
09/16/2006
Last updated
08/22/2014
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