Provider Demographics
NPI:1528052487
Name:THRUMOND, JAMES D (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:THRUMOND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2264
Mailing Address - Country:US
Mailing Address - Phone:419-784-2515
Mailing Address - Fax:419-782-2617
Practice Address - Street 1:424 E 2ND ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2264
Practice Address - Country:US
Practice Address - Phone:419-784-2515
Practice Address - Fax:419-782-2617
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36001666213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02151OtherPHC
OH000000294147OtherAMTHEM
OH7504216OtherAETNA
OHP00038307OtherRRMC
OH0253881Medicaid
OH27-00584OtherUHC
OH27-00584OtherUHC
OHP00038307OtherRRMC