MEDICARE: THOMAS JOSEPH MISNY 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
1	208600000X	Surgery Physician	35-045692	OH

General Provider Information

NPI Number	:	1497044101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JOSEPH MISNY M.D.

Provider Business Mailing Address
First Line	:	7319 EAGLE MILLS ROAD
Second Line	:
City	:	WAITE HILL
State	:	OH
Zip	:	44094
Country	:	US
Telephone Number	:	440-256-4903
Fax Number	:	440-256-1950

Provider Business Practice Location Address
First Line	:	7319 EAGLE MILLS ROAD
Second Line	:
City	:	WAITE HILL
State	:	OH
Zip	:	44094
Country	:	US
Telephone Number	:	440-256-4903
Fax Number	:	440-256-1950

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

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	04/04/2011

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