Individual
DR. THOMAS A AMBROSE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 W TEMPLE AVE STE 2500, EFFINGHAM, IL 62401-2121
(217) 540-2350
(217) 347-2323
Mailing address
900 W TEMPLE AVE STE 2500, EFFINGHAM, IL 62401-2121
(217) 540-2350
(217) 347-2323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01037487A
IN
207X00000X
Orthopaedic Surgery Physician
036172356
IL
207X00000X
Orthopaedic Surgery Physician
Primary
10090
SD
207X00000X
Orthopaedic Surgery Physician
41335
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000247026
ANTHEM PIN
IN
05
—
100357760
—
IN
Enumeration date
05/12/2006
Last updated
01/15/2025
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