Provider Demographics
NPI:1225068125
Name:MCNAMARA, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MCNAMARA
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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-0306
Mailing Address - Country:US
Mailing Address - Phone:775-378-9460
Mailing Address - Fax:775-424-2058
Practice Address - Street 1:2874 N CARSON ST STE 300
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1683
Practice Address - Country:US
Practice Address - Phone:775-888-1180
Practice Address - Fax:775-852-6902
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC295532085R0202X
NV44142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C295530Medicaid
CA00C295530Medicaid
CAWC29553CMedicare PIN
CAWC29553BMedicare PIN