Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 19493 | KY |
N | 207YP0228X | Pediatric Otolaryngology | 19493 | KY |
NPI | 1053499038 |
---|---|
Provider Name | Dr. Thomas Milton Mayer |
First Address | Fort Thomas, KY 41075-4107 |
Second Address | Fort Thomas, KY 41075-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 02/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000033776 | ANTHEM (01) | |
100015770 | (05) | IN |
10-20163 | UNITED HEALTHCARE (01) | |
1046545 | IN MEDICAL LICENSE (01) | IN |
1094 | CHA (01) | |
19493 | KY MEDICAL LICENSE (01) | KY |
35033598 | OH MEDICAL LICENSE (01) | OH |
4044101 | AETNA (01) | |
64194939 | (05) | KY |
65917965 | (05) | KY |
701333 | (05) | OH |
701342 | (05) | OH |
C69370 | (02) |