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NPI Code Detail

MEDICARE: DR. ROGER LYNN THOMAS DO

MEDICARE:  DR. ROGER LYNN 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
1207Q00000XFamily Medicine Physician0518534KS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00099501OTHERKSRAILROAD MEDICARE

General Provider Information

NPI Number : 1942275342
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER LYNN THOMAS DO
Provider Business Mailing Address
First Line : 606 MULBERRY RD
Second Line :
City : DERBY
State : KS
Zip : 67037-3532
Country : US
Telephone Number : 316-788-3787
Fax Number : 316-788-6930
Provider Business Practice Location Address
First Line : 606 MULBERRY RD
Second Line :
City : DERBY
State : KS
Zip : 67037-3532
Country : US
Telephone Number : 316-788-3787
Fax Number : 316-788-6930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 07/19/2013

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Directions to “ DR. ROGER LYNN THOMAS DO” Practice Location

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