Thom, Giddel G A

Thom, Giddel G A is an individual health care provider with primary practice located at 1515 W Fir St , Portales NM 88130-5703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Thom, Giddel G A can be contacted via phone (575) 356-6695.

Contact Information

Primary practice address
1515 W Fir St Portales NM 88130-5703
Phone: (575) 356-6695
Fax: (575) 356-5948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X ME978766 Florida
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X MD2009-0687 New Mexico

Profile Details

NPI number 1700078375
LBN Legal business name Thom, Giddel G A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2007
Last updated May 7th, 2018 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700078375 NPPES
New Mexico MEDICAID 73252875
New Mexico Other ME98766

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