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Individual

THOMAS R SANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1225 S. GRAND, DOOR 3, ST. LOUIS, MO 63104
(314) 977-5110
(314) 977-7686
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-4440

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
109913
MO

Other

Enumeration date
07/17/2006
Last updated
03/12/2021
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