Individual
DR. THOMAS A ROISUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 S 5TH ST, ENID, OK 73701-5832
(913) 396-8509
(913) 318-8378
Mailing address
261 HUMMINGBIRD LN, HANNIBAL, MO 63401-6931
(573) 231-0130
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
109630
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
15065
ND
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34698
OK
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
36424
IA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD479037
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C220032011
RAILROAD MEDICARE
MO
05
—
201085050A
—
OK
05
—
205703408
—
MO
Enumeration date
08/17/2006
Last updated
05/13/2026
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