Individual
KEITH D THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
811 E PARRISH AVE, OWENSBORO, KY 42303-3258
(270) 684-5005
(270) 926-4432
Mailing address
815 E PARRISH AVE, STE 460, OWENSBORO, KY 42303-3222
(270) 684-5005
(270) 926-4432
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01044112A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01044112A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000067774
BLUE SHIELD
IN
01
—
000000683152
ANTHEM
—
05
—
0360915761
—
IL
01
—
050040838
RAILROAD MEDICARE
—
05
—
200047560
—
IN
Enumeration date
05/12/2006
Last updated
05/15/2012
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