MEDICARE: THOMAS L. EWING MD, APMC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	02654	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083683692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS L. EWING MD, APMC

Provider Business Mailing Address
First Line	:	1212 RIVERVIEW BLVD
Second Line	:	SUITE 3000
City	:	GONZALES
State	:	LA
Zip	:	70737-5023
Country	:	US
Telephone Number	:	225-743-2444
Fax Number	:	225-743-2448

Provider Business Practice Location Address
First Line	:	1212 RIVERVIEW BLVD
Second Line	:	SUITE 3000
City	:	GONZALES
State	:	LA
Zip	:	70737-5023
Country	:	US
Telephone Number	:	225-743-2444
Fax Number	:	225-743-2448

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS L. EWING
Credential	:	MD
Telephone Number	:	225-743-2444

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	08/22/2020

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