Provider Demographics
NPI:1437736014
Name:THOMAS, MARLEE DIANA (DO)
Entity type:Individual
Prefix:
First Name:MARLEE
Middle Name:DIANA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 EISENHOWER ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2008
Mailing Address - Country:US
Mailing Address - Phone:636-584-1483
Mailing Address - Fax:
Practice Address - Street 1:725 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1221
Practice Address - Country:US
Practice Address - Phone:413-794-4146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016548207P00000X
MA1022823207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine