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NPI Code Detail

MEDICARE: DR. THOMAS JAY NEILSON M.D.

MEDICARE:  DR. THOMAS JAY NEILSON  M.D.
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
1207R00000XInternal Medicine PhysicianME82070FL
22083P0500XPreventive Medicine/Occupational Environmental Medicine PhysicianME82070FL

General Provider Information

NPI Number : 1174549034
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JAY NEILSON M.D.
Provider Business Mailing Address
First Line : 500 WATER ST # J-290
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32202-4423
Country : US
Telephone Number : 904-359-7645
Fax Number : 904-359-3313
Provider Business Practice Location Address
First Line : 500 WATER ST # J-290
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32202-4423
Country : US
Telephone Number : 904-359-7645
Fax Number : 904-359-3313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 09/11/2025

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Directions to “ DR. THOMAS JAY NEILSON M.D.” Practice Location

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