Individual
DR. THOMAS CORDELL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 WESTWOODS DR, LIBERTY, MO 64068-1181
(816) 781-6127
(816) 792-2265
Mailing address
110 WESTWOODS DR., LIBERTY, MO 64068-1218
(816) 781-6127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28478
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01832015
BCBS
MO
05
—
205285901
—
MO
Enumeration date
06/01/2005
Last updated
10/07/2010
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