Individual
THOMAS S SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10701 NALL AVE, SUITE 200, OVERLAND PARK, KS 66211-1231
(913) 381-5225
(913) 901-0186
Mailing address
12639 OLD TESSON RD, SUITE 100, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0425054
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20871010
BCBS KC
—
01
—
4675214
AETNA
—
01
—
P01049730
RAILROAD MEDICARE
—
Enumeration date
06/29/2006
Last updated
07/29/2019
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