Organization
THOMAS CARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA R THOMAS FNP-BC (CLINIC OWNER)
(417) 275-8900
Entity
Organization
Contact information
Practice address
2040 E SUNSHINE ST, SPRINGFIELD, MO 65804-1815
(417) 275-8900
(417) 270-8012
Mailing address
2040 E SUNSHINE ST, SPRINGFIELD, MO 65804-1815
(417) 275-8900
(417) 270-8012
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154787638
NPPES
MO
05
—
420028118
—
MO
Enumeration date
05/11/2021
Last updated
06/03/2024
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