Individual
KEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-2491
(337) 528-2749
Mailing address
622 CYPRESS ST, SULPHUR, LA 70663-5052
(337) 527-2491
(337) 528-2749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD.200106
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1787159
—
LA
Enumeration date
06/15/2005
Last updated
02/21/2014
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