Provider Demographics
NPI:1871530055
Name:THOMAS, JOBINSON (MD)
Entity type:Individual
Prefix:
First Name:JOBINSON
Middle Name:
Last Name:THOMAS
Suffix:
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 1:411 LAUREL ST STE 2350
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3026
Mailing Address - Country:US
Mailing Address - Phone:515-280-4700
Mailing Address - Fax:515-280-4701
Practice Address - Street 1:411 LAUREL ST STE 2350
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-280-4700
Practice Address - Fax:515-280-4701
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36584207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00329639OtherRR MEDICARE
IA1871530055OtherWELLMARK BCBS
IA1871530055Medicaid
IA1871530055Medicaid
IAI17637Medicare PIN
IAIB1541002Medicare PIN