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Individual

URSULA LOUISE THATCH

Active
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Individual

URSULA LOUISE THATCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036-085831
IL
207VG0400X
Gynecology Physician
36980
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360858311
IL
01
060-10076
IL BCBS
IL
01
1619
MO-BCBS-FACET#
MO
01
6010076
IL-BCBS
IL
Enumeration date
01/17/2007
Last updated
12/17/2008
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