Individual
DR. LEYLAND ARTHUR THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2166 MADISON AVE, GRANITE CITY, IL 62040-4700
(618) 452-3301
(618) 452-3312
Mailing address
2166 MADISON AVE, GRANITE CITY, IL 62040-4700
(618) 452-3301
(618) 452-3312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036084658
IL
207RG0100X
Gastroenterology Physician
036048
MO
207RG0100X
Gastroenterology Physician
036084658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0097200550
BCBS OF ILLINOIS
IL
01
—
135939
BCBS OF MISSOURI
MO
05
—
203425913
—
MO
Enumeration date
03/23/2006
Last updated
06/18/2014
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