Provider Demographics
NPI:1003986050
Name:SPOONHOUR, THOMAS DUANE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DUANE
Last Name:SPOONHOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 N BELL ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-4347
Mailing Address - Country:US
Mailing Address - Phone:402-727-7990
Mailing Address - Fax:402-727-1761
Practice Address - Street 1:8051 W. CENTER ROAD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-391-3333
Practice Address - Fax:402-391-8593
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14388174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist