Roisum, Thomas A
Roisum, Thomas A is an individual health care provider with primary practice located at 6470 Interstate Ct , Hannibal MO 63401-6759. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Roisum, Thomas A can be contacted via phone (573) 248-0826.Contact Information
Primary practice address
6470 Interstate Ct
Hannibal MO 63401-6759
Phone: (573) 248-0826
Fax: (573) 221-2252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 36424 | Iowa |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 15065 | North Dakota |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD479037 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 109630 | Missouri |
Profile Details
| NPI number | 1528171964 |
|---|---|
| LBN Legal business name | Roisum, Thomas A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Jun 26th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528171964 | NPPES |
| Missouri | Other | 1C220032011 | RAILROAD MEDICARE |
| Missouri | MEDICAID | 205703408 | RAILROAD MEDICARE |
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