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Individual

GERALD PAUL THORNBERRY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8166
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 438-8910

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007594RX
OH
363A00000X
Physician Assistant
APP-000599950
OH

Other

Enumeration date
06/03/2022
Last updated
04/14/2026
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