MEDICARE: DR. PATRICK THOMAS MCGRAW 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	208600000X	Surgery Physician	ME96681	FL
2	208600000X	Surgery Physician	054016	GA
3	208600000X	Surgery Physician	21373	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174677124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK THOMAS MCGRAW M.D.

Provider Business Mailing Address
First Line	:	11945 SAN JOSE BLVD
Second Line	:	STE 300
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-1627
Country	:	US
Telephone Number	:	904-396-1725
Fax Number	:	904-396-4893

Provider Business Practice Location Address
First Line	:	1703 LEWIS TURNER BLVD
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-1221
Country	:	US
Telephone Number	:	850-864-4033
Fax Number	:	850-864-4076

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	11/17/2021

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Directions to “ DR. PATRICK THOMAS MCGRAW M.D.” Practice Location

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