Provider Demographics
NPI:1447446398
Name:THOMAS III, MORTON STANLEY III (MD)
Entity type:Individual
Prefix:DR
First Name:MORTON
Middle Name:STANLEY
Last Name:THOMAS III
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:56333 HIWAY 93
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85358-0129
Mailing Address - Country:US
Mailing Address - Phone:928-684-5390
Mailing Address - Fax:
Practice Address - Street 1:56333 HIWAY 93
Practice Address - Street 2:56333 HIWAY 93
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85358-0129
Practice Address - Country:US
Practice Address - Phone:928-684-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine