Individual
DR. THOMAS WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-14490
KS
2085R0202X
Diagnostic Radiology Physician
Primary
R5010
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04772024
BCBS
—
05
—
10015450F
—
KS
Enumeration date
03/03/2006
Last updated
04/18/2008
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