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Individual

THOMAS B FALLOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
42499
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0600040
MEDICA HEALTH PLANS
01
1023510
PREFERRED ONE
01
127844
U CARE
01
140007661
RR MEDICARE
01
1927405
FIRST HEALTH PLAN
01
480677800
MEDICAL ASSISTANCE
01
85D65FA
BLUE CROSS BLUE SHIELD
01
996067
ARAZ GROUP AMERICAS PPO
01
CI1369
RR MEDICARE
01
HP30505
HEALTH PARTNERS
Enumeration date
10/28/2005
Last updated
11/28/2011
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