Individual
RICHARD SHANNON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
JD, DO
Contact information
Practice address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 248-5100
(573) 248-5114
Mailing address
PO BOX 551, HANNIBAL, MO 63401-0551
(573) 248-1300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021014796
MO
207P00000X
Emergency Medicine Physician
5101023483
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101023483
STATE OF MICHIGAN
MI
Enumeration date
06/28/2017
Last updated
07/21/2021
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