NPIMap

Gary N Thomsen, M.D.

Individual provider Active NPI Family Medicine Physician · Iberia, MO

NPI 1164515029 · NPPES record last updated Mar 27, 2017

Key facts

NPI
1164515029
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
2008037063 (MO)
Practice address
2333 Highway 17
Iberia, MO 65486-9331
Phone
(573) 793-6900
Fax
(573) 793-6688
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008037063MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Welgen One of Missouri LLC Past Accepting new patients
Shawnee Mission Medical Center, Inc. Family Medicine Past Accepting new patients
Shawnee Mission Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2008037063 MO Yes

Addresses

Primary practice location

2333 Highway 17
Iberia, MO 65486-9331

Mailing address

2333 Highway 17
Iberia, MO 65486-9331
Phone (573) 793-6900

Other providers in Iberia, MO

All providers in Iberia, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.