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General NPI Number Information
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NPI Number | 1821061805
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Entity Type | Individual
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Provider Name | THOMAS SAMUEL PAXMAN DO
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Gender | Male
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 728 E WHITE MOUNTAIN BLVD SUITE A
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City | PINETOP
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State | AZ
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Zip | 85935-7027
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Country | US
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Telephone | 928-367-6688
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Fax | 928-367-4916
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Provider Business Mailing Address
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Address Line | PO BOX 2690
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City | PINETOP
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State | AZ
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Zip | 85935-7027
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Country | US
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Telephone | 928-367-6688
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Fax | 928-367-4916
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 2577
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2577
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License Number State | AZ
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