Individual
DR. MARK KIERNAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 SE STRATUS AVE UNIT 303, MCMINNVILLE, OR 97128-6257
(503) 435-4520
Mailing address
2700 SE STRATUS AVE UNIT 303, MCMINNVILLE, OR 97128-6257
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD180256
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100011285
TENNCARE
TN
01
—
1315687
UNITED HEALTH CARE
TN
01
—
3071396
BLUE CROSS BLUE SHIELD
TN
05
—
3092413
—
TN
01
—
4496138
AETNA
TN
01
—
P00259915
RAILROAD MEDICARE
TN
01
—
TN0134
JOHN DEERE HEALTHCARE
TN
01
—
TN0184
JOHN DEERE HEALTHCARE
TN
Enumeration date
03/15/2006
Last updated
03/13/2019
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