Provider Demographics
NPI:1710946504
Name:SOMMERS, THOMAS S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:SOMMERS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:510 BAXTER RD
Mailing Address - Street 2:SUITE 10N
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7032
Mailing Address - Country:US
Mailing Address - Phone:636-492-1323
Mailing Address - Fax:714-631-8902
Practice Address - Street 1:510 BAXTER RD
Practice Address - Street 2:SUITE 10N
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7032
Practice Address - Country:US
Practice Address - Phone:636-492-1323
Practice Address - Fax:714-631-8902
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-02-05
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Provider Licenses
StateLicense IDTaxonomies
MO113174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO967675280Medicare PIN
H04585Medicare UPIN