Individual
WAYNE ERIC THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2828 HIGHWAY 31 S, SUITE 109, DECATUR, AL 35603-1510
(256) 351-1591
(256) 351-1596
Mailing address
2828 HIGHWAY 31 S, SUITE 109, DECATUR, AL 35603-1510
(256) 351-1591
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00014586
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000019709
—
AL
01
—
51019709
BLUE CROSS
AL
01
—
63-1004625
COMMERCIAL
—
Enumeration date
09/06/2005
Last updated
01/24/2008
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