MEDICARE: THOMAS QUINN

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	207Q00000X	Family Medicine Physician	35-04-5399-Q	OH

General Provider Information

NPI Number	:	1467489898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS QUINN

Provider Business Mailing Address
First Line	:	555 W SCHROCK RD
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8702
Country	:	US
Telephone Number	:	614-891-0005
Fax Number	:	614-890-3614

Provider Business Practice Location Address
First Line	:	555 W SCHROCK RD
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8702
Country	:	US
Telephone Number	:	614-891-0005
Fax Number	:	614-890-3614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/12/2013

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Directions to “ THOMAS QUINN ” Practice Location

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