Individual
DR. THOM S THOMASSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3524 E MILWAUKEE ST, JANESVILLE, WI 53546-1626
(608) 756-7100
Mailing address
3524 E MILWAUKEE ST, JANESVILLE, WI 53546-1626
(608) 756-7100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036-092307
IL
207W00000X
Ophthalmology Physician
Primary
34177
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31929600
—
WI
Enumeration date
01/04/2007
Last updated
09/29/2011
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