Healthcare Provider Details

I. General information

NPI: 1225185572
Provider Name (Legal Business Name): THOMAS J. AUGAT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 PLEASANT ST
BRUNSWICK ME
04011-2247
US

IV. Provider business mailing address

9 PLEASANT ST
BRUNSWICK ME
04011-2247
US

V. Phone/Fax

Practice location:
  • Phone: 207-725-7177
  • Fax: 207-725-5600
Mailing address:
  • Phone: 207-725-7177
  • Fax: 207-725-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCR737
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: