Individual
THOMAS R. MARCELLINO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6265 ROCK CHALK DR, SUITE 1100, LAWRENCE, KS 66049
(785) 842-5070
(785) 505-5264
Mailing address
6265 ROCK CHALK DR, SUITE 1100, LAWRENCE, KS 66049
(785) 842-5070
(785) 505-5264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-32383
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200550800B
—
KS
Enumeration date
01/19/2006
Last updated
12/16/2020
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