Provider Demographics
NPI:1730595141
Name:THOMAS, JUSTIN D (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 PRESTIGE PL STE 550
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1310
Mailing Address - Fax:937-762-1310
Practice Address - Street 1:165 S EDWIN C MOSES BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-8472
Practice Address - Country:US
Practice Address - Phone:937-558-0200
Practice Address - Fax:937-558-0202
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34012718207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine