Provider Demographics
NPI:1720057870
Name:FLYNN, THOMAS P (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:FLYNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:651-222-6786
Practice Address - Street 1:910 E 26TH ST
Practice Address - Street 2:SUITE 100-200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4526
Practice Address - Country:US
Practice Address - Phone:612-884-6300
Practice Address - Fax:612-884-6363
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN23520207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0104003OtherPREFERREDONE
WI30329300Medicaid
MN8T403FLOtherBLUE CROSS BLUE SHIELD
MN106111OtherUCARE MN
MN3600776OtherMEDICA
MN235200100Medicaid
MNHP13299OtherHEALTHPARTNERS
IA1983148Medicaid
MN23324OtherAMERICA'S PPO
MN106111OtherUCARE MN
MNHP13299OtherHEALTHPARTNERS
IA1983148Medicaid