Provider Demographics
NPI:1962468926
Name:FREE, THOMAS W (DO)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:W
Last Name:FREE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:605-328-6512
Practice Address - Street 1:1210 W 18TH ST
Practice Address - Street 2:STE LL03
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4647
Practice Address - Country:US
Practice Address - Phone:605-328-1410
Practice Address - Fax:605-328-1412
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2018-02-17
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Provider Licenses
StateLicense IDTaxonomies
SD33562085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7200340Medicaid
SD7200340Medicaid
E78838Medicare UPIN