Basic Information
Provider Information
NPI: 1003899626
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CROPLEY
FirstName: THOMAS
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9007
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229069007
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1221 LEE ST
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229080001
CountryCode: US
TelephoneNumber: 4349245115
FaxNumber: 4342444504
Other Information
ProviderEnumerationDate: 11/29/2005
LastUpdateDate: 07/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000X0101242840VAY Allopathic & Osteopathic PhysiciansDermatology 

ID Information
IDTypeStateIssuerDescription
303142005MA MEDICAID
100389962605VA MEDICAID


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