Provider Demographics
NPI:1669423695
Name:TOMAS, A (MD)
Entity type:Individual
Prefix:DR
First Name:A
Middle Name:
Last Name:TOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:944 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-3614
Mailing Address - Country:US
Mailing Address - Phone:815-223-4870
Mailing Address - Fax:815-223-7040
Practice Address - Street 1:1100 E NORRIS DR, DEPT OF PATHOLOGY
Practice Address - Street 2:COMMUNITY HOSPITAL OF OTTAWA
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1604
Practice Address - Country:US
Practice Address - Phone:815-223-4870
Practice Address - Fax:815-223-7040
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5000298OtherBCBS
IL1225212236OtherNPI
IL740110Medicare PIN