Provider Demographics
NPI:1831537810
Name:WATERS, THOMAS S (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:WATERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:IOWA FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50126-9506
Mailing Address - Country:US
Mailing Address - Phone:641-648-7000
Mailing Address - Fax:
Practice Address - Street 1:2501 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3725
Practice Address - Country:US
Practice Address - Phone:712-294-5000
Practice Address - Fax:712-294-5091
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR-9819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine