Provider Demographics
NPI:1386644078
Name:MAIN, THOMAS S (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:MAIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:974 BETHEL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2467
Mailing Address - Country:US
Mailing Address - Phone:614-538-2424
Mailing Address - Fax:614-538-2418
Practice Address - Street 1:974 BETHEL RD
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2467
Practice Address - Country:US
Practice Address - Phone:614-538-2424
Practice Address - Fax:614-538-2418
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35032586207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0275063Medicaid
OH0275063Medicaid
F13518Medicare UPIN