Provider Demographics
NPI:1336138643
Name:HUME, THOMAS HOUSTON II (PA-C MPAS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HOUSTON
Last Name:HUME
Suffix:II
Gender:M
Credentials:PA-C MPAS
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Mailing Address - Street 1:126 MISSOURI AVE
Mailing Address - Street 2:GLWACH ATTN MCXP CCS CR
Mailing Address - City:FORT LEONARD WOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65473-8952
Mailing Address - Country:US
Mailing Address - Phone:573-596-0417
Mailing Address - Fax:573-596-0524
Practice Address - Street 1:126 MISSOURI AVE
Practice Address - Street 2:GLWACH ATTN MCXP CCS CR
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:MO
Practice Address - Zip Code:65473-8952
Practice Address - Country:US
Practice Address - Phone:573-596-0417
Practice Address - Fax:573-596-0524
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant