Thornburg, Carroll Wayne

Thornburg, Carroll Wayne is an sole proprietor health care provider with primary practice located at 725 S Mesa Hills Dr Suite 1, Bldg. 1, El Paso TX 79912-5568. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Thornburg, Carroll Wayne can be contacted via phone (915) 887-3414.

Contact Information

Primary practice address
725 S Mesa Hills Dr Suite 1, Bldg. 1 El Paso TX 79912-5568
Phone: (915) 887-3414
Fax: (915) 585-1682
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X G9230 Texas

Profile Details

NPI number 1568460962
LBN Legal business name Thornburg, Carroll Wayne
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2005
Last updated Nov 23rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568460962 NPPES
New Mexico MEDICAID E0068

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