MEDICARE: AMANDA THOMAS DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	2023014181	MO

General Provider Information

NPI Number	:	1629607874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA THOMAS DO

Provider Business Mailing Address
First Line	:	8380 N TULLIS AVE STE 300
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-5114
Country	:	US
Telephone Number	:	816-407-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	8380 N TULLIS AVE STE 300
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-5114
Country	:	US
Telephone Number	:	816-415-3451
Fax Number	:

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

Provider Enumeration Date	:	04/08/2020
Last Update Date	:	07/05/2023

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Directions to “ AMANDA THOMAS DO” Practice Location

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