MEDICARE: DR. THOMAS HARRY WEBB III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	21517	NE
2	2086S0129X	Vascular Surgery Physician	33729	IA
3	2086S0129X	Vascular Surgery Physician	01074731A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4707367990006	OTHER	NE	UPREHS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	229939	OTHER	NE	MIDLANDS CHOICE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	43494	OTHER	IA	IA BCBS
6	770002435	OTHER	NE	RAILROAD
7	03482	OTHER	NE	BCBS NE

General Provider Information

NPI Number	:	1093795528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS HARRY WEBB III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 781076
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48278-1076
Country	:	US
Telephone Number	:	317-528-4800
Fax Number	:	317-865-1479

Provider Business Practice Location Address
First Line	:	5255 E STOP 11 RD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-6341
Country	:	US
Telephone Number	:	317-851-2331
Fax Number	:	317-851-2333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/15/2025

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