MEDICARE: DR. THOMAS C PEARSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	R6N04	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R6N04	OTHER	MS	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689676579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS C PEARSON M.D.

Provider Business Mailing Address
First Line	:	1256 S POST OAK CT
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65809-1624
Country	:	US
Telephone Number	:	417-875-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1256 S POST OAK CT
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65809-1624
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	03/14/2023

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