Individual
DR. JEFFREY L THOMASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 S NEW BALLAS RD, DEPT OF RADIOLOGY, SAINT LOUIS, MO 63141-8221
(314) 251-6031
(314) 251-6343
Mailing address
11475 OLDE CABIN RD, SUITE 200, SAINT LOUIS, MO 63141-7128
(314) 991-8200
(314) 991-8206
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
R2D56
MO
2085R0202X
Diagnostic Radiology Physician
R2D56
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202107637
—
MO
Enumeration date
04/12/2006
Last updated
09/04/2009
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