Healthcare Provider Details

I. General information

NPI: 1386829273
Provider Name (Legal Business Name): ROBERT F THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 I 70 DR SE SUITE 106
COLUMBIA MO
65201-6522
US

IV. Provider business mailing address

18570 MELROSE WOODS DR
WILDWOOD MO
63038-1619
US

V. Phone/Fax

Practice location:
  • Phone: 573-256-7637
  • Fax: 573-817-3103
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number31748
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: