Provider Demographics
NPI:1780992719
Name:3RD OPINION CO.
Entity type:Organization
Organization Name:3RD OPINION CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SULT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:320-347-1212
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-0607
Mailing Address - Country:US
Mailing Address - Phone:320-347-1212
Mailing Address - Fax:320-347-1200
Practice Address - Street 1:7900 CHAPIN DR NE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MN
Practice Address - Zip Code:56273-8538
Practice Address - Country:US
Practice Address - Phone:320-347-1212
Practice Address - Fax:320-347-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN37054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN534225200Medicaid
MN534225200Medicaid