Individual
DR. MARK B THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., D.A.B.C.I.
Contact information
Practice address
500 E WHITEAKER AVE, COTTAGE GROVE, OR 97424-1648
(541) 942-5024
(541) 942-0598
Mailing address
500 E WHITEAKER AVE, COTTAGE GROVE, OR 97424-1648
(541) 942-5024
(541) 942-0598
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
271279
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067246000
BLUE CROSS
OR
01
—
067246002
BLUE CROSS
OR
05
—
231779
—
OR
Enumeration date
01/16/2007
Last updated
07/08/2007
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