Individual
DR. JEB THOMAS LIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 741-1095
Mailing address
14441 DUPONT CT STE 304, OMAHA, NE 68144-2107
(402) 597-8775
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
29954
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2014
Last updated
12/14/2020
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