Jon-marc Thibodeau PA-C

NPI 1003119744 - Physician Assistant - 363A00000X

NPI Details
NPI 1003119744
Gender Male
Enumeration Date 12/20/2010
Last Updated 12/20/2010
Entity Type Individual
Active Over 5 years ago
Practice Location
289 IRELAND AVE
IRELAND ARMY COMMUNITY HOSPITAL
FORT KNOX KY, 40121-5111, US
Phone (502) 624-9007
Fax (502) 624-0252
Business Location
289 IRELAND AVE
IRELAND ARMY COMMUNITY HOSPITAL
FORT KNOX KY, 40121-5111, US
Phone (502) 624-9007
Fax (502) 624-0252
Toxanomy
Taxonomy Code 363A00000X
License State
License Number 1095643
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According to our database, Mr. Jon-marc Thibodeau PA-C NPI is 1003119744, taxonomy code is 363A00000X and license number is 1095643, license state is located at . Jon-marc Thibodeau PA-C physically located at 289 Ireland Ave, Fort Knox KY, 40121-5111. NPI Number Jon-marc Thibodeau PA-C has the Individual type.

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1003119744 NPI number is provided on an as is basis without warranty of any kind. 1003119744 is maintained by the National Plan & Provider Enumeration System. The contents of Jon-marc Thibodeau PA-C are for informational purposes only.