Individual
THOMAS B COY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3302 MCINTOSH CIR, STE 1, JOPLIN, MO 64804-3648
(417) 347-7272
(417) 347-7915
Mailing address
PO BOX 3810, JOPLIN, MO 64803
(417) 347-7272
(417) 347-7915
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
114648
MO
2086S0129X
Vascular Surgery Physician
114648
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020054312
RR MEDICARE
—
05
—
100055980B
—
OK
05
—
100318490B
—
KS
01
—
131363
ANTHEM
MO
05
—
249812405
—
MO
Enumeration date
06/27/2006
Last updated
05/16/2016
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