Individual
ROGER W THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9585
MN
363AM0700X
Medical Physician Assistant
9585
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110929
MEDICA #
MN
01
—
1156275
AMERICA'S PPO/ARAZ #
MN
01
—
142352
UCARE #
MN
01
—
19315
NDBS #
MN
01
—
19315
NDBS #
ND
05
—
517450300
—
MN
01
—
89D48TH
MNBS #
MN
01
—
DA9021027003
PREFERRED ONE #
MN
01
—
HP38586
HEALTHPARTNERS #
MN
01
—
P00979630
RAILROAD MEDICARE
MN
Enumeration date
07/03/2006
Last updated
12/22/2011
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