MEDICARE: JON V. THOMAS 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	207Y00000X	Otolaryngology Physician	32769	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1028100	OTHER	MN	MEDICA CHOICE
2	1000216	OTHER	MN	PREFERREDONE
3	1000010	OTHER	MN	MEDICA PRIMARY
4	20852	OTHER	MN	AMERICA'S PPO
5	102389	OTHER	MN	UCARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	38T56TH	OTHER	MN	BLUE SHIELD
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467453597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JON V. THOMAS M.D.

Provider Business Mailing Address
First Line	:	720 WASHINGTON AVE SE STE 300
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-2904
Country	:	US
Telephone Number	:	612-672-7422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1687 E DIVISION ST
Second Line	:
City	:	RIVER FALLS
State	:	WI
Zip	:	54022-1571
Country	:	US
Telephone Number	:	715-425-6701
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	12/03/2019

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Directions to “ JON V. THOMAS M.D.” Practice Location

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