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Individual

ADAM KEITH THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-2345
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-2345

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28211491A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100154170
KY
Enumeration date
12/06/2010
Last updated
11/13/2013
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