Individual
MATT E THORNBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(573) 443-2402
(573) 443-0574
Mailing address
1 S KEENE ST, COLUMBIA, MO 65201-7199
(573) 443-2402
(573) 443-0574
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2000161380
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203746714
—
MO
Enumeration date
09/07/2005
Last updated
03/17/2025
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