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NPI Code Detail

MEDICARE: DR. LIEM THAT TON M.D.

MEDICARE: DR. LIEM THAT TON 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
1208D00000XGeneral Practice PhysicianME46305FL

Other Identifiers

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

General Provider Information

NPI Number : 1497846182
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LIEM THAT TON M.D.
Provider Business Mailing Address
First Line : 500 E CENTRAL AVE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3053
Country : US
Telephone Number : 863-293-1191
Fax Number :
Provider Business Practice Location Address
First Line : 325 1ST ST N
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33881-4111
Country : US
Telephone Number : 863-293-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 03/14/2018

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Directions to “ DR. LIEM THAT TON M.D.” Practice Location

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