Individual
ADAM THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2605 N LEBANON ST, LEBANON, IN 46052-1476
(765) 485-8000
Mailing address
PO BOX 804, LAFAYETTE, IN 47902-0804
(765) 485-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075375A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000949479
ANTHEM
IN
05
—
201102390
—
IN
Enumeration date
05/22/2012
Last updated
09/21/2015
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