Individual
THOMAS C REALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3311 E MURDOCK ST, WICHITA, KS 67208-3054
(316) 689-9834
(316) 689-9889
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21933
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060630
BCBS
KS
01
—
100005
HPK
KS
01
—
2537
PHS
KS
01
—
25560
COVENTRY
KS
Enumeration date
06/18/2006
Last updated
07/13/2007
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