Individual
THOMAS JAMES RENTFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6345 S EAST ST, SUITE A, INDIANAPOLIS, IN 46227-7107
(317) 783-7474
Mailing address
205 E SANTA MARIA AVE, EFFINGHAM, IL 62401-3025
(217) 347-5736
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-080231
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01058033A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036080231
—
IL
05
—
036080231-6
—
IL
05
—
200474410
—
IN
Enumeration date
07/09/2006
Last updated
05/04/2009
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