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General NPI Number Information
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NPI Number | 1205879459
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Entity Type | Individual
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Provider Name | THOMAS LLOYD EDWARDS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12844 JOE HARIG RD
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City | SAN ANTONIO
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State | FL
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Zip | 33576-0537
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Country | US
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Telephone | 352-206-4165
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Fax | 888-523-3008
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Provider Business Mailing Address
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Address Line | PO BOX 537
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City | SAN ANTONIO
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State | FL
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Zip | 33576-0537
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Country | US
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Telephone | 352-206-4165
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Fax | 888-523-3008
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-0006349
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | OS6349
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License Number State | FL
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