Provider Demographics
NPI:1578652574
Name:THOMAS, ROGER A (DO)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15435 W 134TH PL
Mailing Address - Street 2:101
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6135
Mailing Address - Country:US
Mailing Address - Phone:913-780-0030
Mailing Address - Fax:913-782-2924
Practice Address - Street 1:15435 W 134TH PL
Practice Address - Street 2:101
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6135
Practice Address - Country:US
Practice Address - Phone:913-780-0030
Practice Address - Fax:913-782-2924
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS05-24923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200735980DMedicaid
F11103Medicare UPIN
KS033D00092Medicare PIN