Individual
JENNIFER M THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 GAVOTTE LN, ANDERSON, SC 29621-8205
(864) 261-7474
(864) 261-8580
Mailing address
100 GAVOTTE LN, ANDERSON, SC 29621-8205
(864) 261-7474
(864) 261-8580
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2007-00336
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01078673
RR MEDICARE
SC
01
—
P01317465
RR MEDICARE
SC
Enumeration date
05/15/2007
Last updated
07/21/2022
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