Individual
THOMAS H TARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 W MCKINLEY AVE STE 1, DECATUR, IL 62526-5858
(217) 876-6600
(217) 876-6606
Mailing address
210 W MCKINLEY AVE STE 1, DECATUR, IL 62526-5858
(217) 876-6600
(217) 876-6606
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
036092911
IL
208800000X
Urology Physician
036092911
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092911
—
IL
Enumeration date
09/23/2005
Last updated
04/29/2015
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