Provider Demographics
NPI:1174534846
Name:THOMAS, KATHERINE M (DO)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:5041 N 12TH AVE
Mailing Address - Street 2:COVENANT HOSPICE CORPORATE OFC
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504
Mailing Address - Country:US
Mailing Address - Phone:850-433-2155
Mailing Address - Fax:850-202-0600
Practice Address - Street 1:6475 VAN BUREN STREET
Practice Address - Street 2:COVENANT HOSPICE
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526
Practice Address - Country:US
Practice Address - Phone:251-626-5255
Practice Address - Fax:251-626-5922
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
ALDO862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E29650Medicare UPIN
012265Medicare ID - Type Unspecified