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General NPI Number Information
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NPI Number | 1578274866
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Entity Type | Organization
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Legal Business Name | THOMAS RAULERSON MD AND FARM INC
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 01/08/2023
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Provider Practice Location Address
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Address Line | 926 NW 13TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32601-4140
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Country | US
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Telephone | 352-283-4449
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Fax | 352-505-4046
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Provider Business Mailing Address
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Address Line | 3336 NW 142ND AVE
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City | GAINESVILLE
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State | FL
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Zip | 32609-4098
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Country | US
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Telephone | 352-283-4449
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Fax | 352-505-4046
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS JOHN RAULERSON
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Credential | MD
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Telephone | 352-283-4449
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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