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Individual
RICK THORNTON
Active
Individual
RICK THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
016005314
IL
213E00000X
Podiatrist
Primary
299
AL
213E00000X
Podiatrist
689
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636612
BCBS PROVIDER #
IL
01
—
06-1763397
TAX ID #
IL
05
—
112600
—
AL
01
—
510-49599
BCBSAL
AL
Enumeration date
06/18/2007
Last updated
01/09/2023
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