Individual
DR. THADDEAUS VERNON V
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2501 PIERCE ST, SIOUX CITY, IA 51104-3725
(712) 294-5000
(712) 294-5091
Mailing address
2501 PIERCE ST, SIOUX CITY, IA 51104-3725
(712) 294-5000
(712) 294-5091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36310
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0475871
—
IA
Enumeration date
02/21/2006
Last updated
07/08/2007
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