Wyman, Thomas M
Wyman, Thomas M is an individual health care provider with primary practice located at 8921 N. Wood Sage Rd. , Peoria IL 61615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wyman, Thomas M can be contacted via phone (309) 243-2400.Contact Information
Primary practice address
8921 N. Wood Sage Rd.
Peoria IL 61615
Phone: (309) 243-2400
Fax: (309) 243-7918
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036045786 | Illinois |
Profile Details
| NPI number | 1245227669 |
|---|---|
| LBN Legal business name | Wyman, Thomas M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Jul 28th, 2020 - about 4 years ago |
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 | 1245227669 | NPPES |
| Illinois | MEDICAID | 036045786 | |
| Illinois | Other | 180014617 |
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