Individual
DR. THOMAS JAMES GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2603 KENTUCKY AVE, SUITE 404, PADUCAH, KY 42003-3814
(270) 443-6472
(270) 442-1649
Mailing address
PO BOX 7909, PADUCAH, KY 42002-7909
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
45110
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100202710
—
KY
Enumeration date
01/09/2012
Last updated
12/03/2020
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