Provider Demographics
NPI:1275714958
Name:THOMAS, LANI STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LANI
Middle Name:STEVEN
Last Name:THOMAS
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 3233
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3233
Mailing Address - Country:US
Mailing Address - Phone:844-584-2194
Mailing Address - Fax:844-278-2154
Practice Address - Street 1:1840 MEDICAL CENTER PKWY
Practice Address - Street 2:SUITE 405
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-396-4282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN458872085R0202X, 2085R0204X
MS192962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1519723Medicaid
TN4265765OtherBCBS OF TN
TN103I302740Medicare PIN
TN1519723Medicaid