Thomas L Edwards Do Inc | |
12844 Joe Harig Road San Antonio FL 33576 | |
(352) 588-0476 | |
(888) 523-3008 |
Full Name | Thomas L Edwards Do Inc |
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Speciality | Family Medicine |
Location | 12844 Joe Harig Road, San Antonio, Florida |
Authorized Official Name and Position | Thomas Lloyd Edwards (PRESIDENT) |
Authorized Official Contact | 3525880476 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thomas L Edwards Do Inc 12844 Joe Harig Road San Antonio FL 33576 Ph: (352) 588-0476 | Thomas L Edwards Do Inc 12844 Joe Harig Road San Antonio FL 33576 Ph: (352) 588-0476 |
NPI Number | 1447439229 |
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Provider Enumeration Date | 10/30/2007 |
Last Update Date | 06/27/2016 |
Medicare PECOS PAC ID | 2769560895 |
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Medicare Enrollment ID | O20080415000497 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447439229 | NPI | - | NPPES |
370860800 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Thomas L Edwards |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205879459 PECOS PAC ID: 6406755784 Enrollment ID: I20040331000941 |
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