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Individual

JARRED J THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
530 S JACKSON ST # C07, LOUISVILLE, KY 40202-1675
(502) 852-5689
(205) 975-4662
Mailing address
PO BOX 11407 DRAWER 624, BIRMINGHAM, AL 35246-0624

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
53535
KY
207P00000X
Emergency Medicine Physician
MD.25556
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051522493
AL
05
051556261
AL
05
116526
AL
01
1992753966
TRICARE SOUTH
AL
01
515-41678
BCBS
AL
Enumeration date
05/04/2006
Last updated
04/07/2020
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