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Contact Information

GIDDEL G THOM, MD
1515 W FIR ST
PORTALES, NM88130-5703
 Phone: 575-356-6695
 Fax: 575-356-5948
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Hematology-Oncology

2080P0207X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for GIDDEL G THOM · (Male)

NPI # 1700078375
Status Active
Credentials MD
Entity Individual
Enumeration date 08/16/2007
Last updated 05/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME978766
  • NM License # MD2009-0687
  • NM Medicaid 73252875
  • FL Other ME98766 MEDICAL LICENCE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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