Basic Information
| Provider Information | |||||||||
| NPI: | 1245246263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11606 NICHOLAS ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681544478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024933712 | ||||||||
| FaxNumber: | 4024938341 | ||||||||
| Practice Location | |||||||||
| Address1: | 11606 NICHOLAS ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681544478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024933712 | ||||||||
| FaxNumber: | 4024938341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 03/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 22901 | NE | Y | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 35727 | IA | N | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 37582 | 01 | IA | WELLMARK | OTHER | 47084218400 | 05 | NE | MEDICAID | 04289 | 01 | NE | BLUE CROSS & BLUE SHIELD | OTHER | 244687 | 01 | NE | MIDLANDS CHOICE | OTHER | 0586289 | 01 | IA | IOWA MEDICAID | OTHER | P00182839 | 01 | NE | RAILROAD MEDICARE | OTHER | 0800818 | 01 | NE | UNITED HEALTHCARE | OTHER | I12596 | 01 | IA | IOWA MEDICARE | OTHER |