Individual
MR. CHARLES E THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3312 HENRY RD, ANNISTON, AL 36207-6344
(256) 241-2671
(256) 241-2676
Mailing address
3312 HENRY RD, ANNISTON, AL 36207-6344
(256) 241-2671
(256) 241-2676
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-084368
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122018
—
AL
01
—
511-09542
BLUE CROSS BLUE SHIELD OF ALABAMA
AL
Enumeration date
08/09/2006
Last updated
07/22/2014
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