| Diane M Thomas M D P C | |
|
4868 Sparks Blvd Suite 102 Sparks NV 89436-8207 | |
| (775) 331-5023 | |
| (775) 331-5031 |
| Full Name | Diane M Thomas M D P C |
|---|---|
| Speciality | Family Medicine |
| Location | 4868 Sparks Blvd, Sparks, Nevada |
| Authorized Official Name and Position | Diane M Thomas (OWNER) |
| Authorized Official Contact | 7753315023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane M Thomas M D P C 4868 Sparks Blvd Suite 102 Sparks NV 89436-8207 Ph: (775) 331-5023 | Diane M Thomas M D P C 4868 Sparks Blvd Suite 102 Sparks NV 89436-8207 Ph: (775) 331-5023 |
| NPI Number | 1689860942 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 07/22/2021 |
| Medicare PECOS PAC ID | 5890773097 |
|---|---|
| Medicare Enrollment ID | O20040713001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689860942 | NPI | - | NPPES |
| 2016817 | Medicaid | NV | |
| 29D1015353 | Other | NV | CLIA |
| DQ4188 | Other | NV | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9450 (Nevada) | Primary |
| Provider Name | Diane M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124006044 PECOS PAC ID: 7315925518 Enrollment ID: I20100524000130 |
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