Individual
MR. THOMAS ALLEN SULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7900 CHAPIN DR NE, NEW LONDON, MN 56273-8538
(320) 347-1212
(320) 347-1200
Mailing address
PO BOX 607, NEW LONDON, MN 56273-0607
(320) 347-1212
(320) 347-1200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37054
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-09668
MEDICA
MN
01
—
031216004
PRIME WEST
MN
01
—
110486P539
UCARE
MN
01
—
1219767
ARAZ
MN
01
—
169318P539
UCARE
MN
01
—
1770646937
UNICARE
MN
01
—
31T18IN
BCBS
MN
01
—
376SISU
BLUE CROSS BLUE SHEILD
MN
05
—
534225200
—
MN
01
—
9823046
MEDICA
MN
01
—
HP11557
HEALTH PARTNERS
MN
01
—
MR143-1001629
PREFERRED ONE
MN
Enumeration date
07/07/2005
Last updated
11/11/2015
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