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1922068121

NPI Code Detail

MEDICARE: DR. LEYLAND ARTHUR THOMAS MD

MEDICARE: DR. LEYLAND ARTHUR THOMAS MD

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	207RG0100X	Gastroenterology Physician	036084658	IL
2	207RG0100X	Gastroenterology Physician	036048	MO
3	207R00000X	Internal Medicine Physician	036084658	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	135939	OTHER	MO	BCBS OF MISSOURI
2	0097200550	OTHER	IL	BCBS OF ILLINOIS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922068121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEYLAND ARTHUR THOMAS MD

Provider Business Mailing Address
First Line	:	2166 MADISON AVE
Second Line	:
City	:	GRANITE CITY
State	:	IL
Zip	:	62040-4700
Country	:	US
Telephone Number	:	618-452-3301
Fax Number	:	618-452-3312

Provider Business Practice Location Address
First Line	:	2166 MADISON AVE
Second Line	:
City	:	GRANITE CITY
State	:	IL
Zip	:	62040-4700
Country	:	US
Telephone Number	:	618-452-3301
Fax Number	:	618-452-3312

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	06/18/2014

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Directions to “ DR. LEYLAND ARTHUR THOMAS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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