Healthcare Provider Details

I. General information

NPI: 1881758019
Provider Name (Legal Business Name): THOMAS W QUIGLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 GLENLAKE DR STE 250
CHARLOTTE NC
28208-6866
US

IV. Provider business mailing address

3735 GLENLAKE DR STE 250
CHARLOTTE NC
28208-6866
US

V. Phone/Fax

Practice location:
  • Phone: 704-749-5800
  • Fax: 704-626-3272
Mailing address:
  • Phone: 704-749-5800
  • Fax: 704-626-3272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2017-01235
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number33689
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: