Basic Information
| Provider Information | |||||||||
| NPI: | 1770849317 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMA | ||||||||
| FirstName: | TRISHA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | THOMSPSON | ||||||||
| OtherFirstName: | TRISHA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 250 S CRESCENT DR | ||||||||
| Address2: | |||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414945400 | ||||||||
| FaxNumber: | 6414945403 | ||||||||
| Practice Location | |||||||||
| Address1: | 250 S CRESCENT DR | ||||||||
| Address2: | |||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414945380 | ||||||||
| FaxNumber: | 6414945381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2012 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0007X | MD44577 | IA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Otolaryngology | Plastic Surgery within the Head & Neck |
No ID Information.