Healthcare Provider Details

I. General information

NPI: 1588636484
Provider Name (Legal Business Name): ERIC R THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 S MINNESOTA AVE STE 200
SIOUX FALLS SD
57108
US

IV. Provider business mailing address

6601 S MINNESOTA AVE STE 200
SIOUX FALLS SD
57108-2564
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-6294
  • Fax: 605-336-0266
Mailing address:
  • Phone: 605-336-6294
  • Fax: 605-336-0266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number6006
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number6006
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: