Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 416187 | KS |
NPI | 1053370965 |
---|---|
Provider Name | Norman W Thoms |
First Address | Lawrence, KS 66044-1335 |
Second Address | Lawrence, KS 66044-1335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B69079 | (02) |