Jevon, Thomas Russell
Jevon, Thomas Russell is an sole proprietor health care provider with primary practice located at 30 Newcrossing Rd Ste 301 , Reading MA 01867-3254. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jevon, Thomas Russell can be contacted via phone (781) 942-0380.Contact Information
Primary practice address
30 Newcrossing Rd Ste 301
Reading MA 01867-3254
Phone: (781) 942-0380
Fax: (781) 942-0371
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 58057 | Massachusetts |
Profile Details
| NPI number | 1104898022 |
|---|---|
| LBN Legal business name | Jevon, Thomas Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Jan 28th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104898022 | NPPES |
| Massachusetts | MEDICAID | 110044837/A |
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