MEDICARE: THOMAS W. OWNBY JR. M.D. P.A.

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	207R00000X	Internal Medicine Physician	ME26254	FL

General Provider Information

NPI Number	:	1386731594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS W. OWNBY JR. M.D. P.A.

Provider Business Mailing Address
First Line	:	510 PALMETTO ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7325
Country	:	US
Telephone Number	:	386-427-5218
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 PALMETTO ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7325
Country	:	US
Telephone Number	:	386-427-5218
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS WOODARD OWNBY JR.
Credential	:	M.D.
Telephone Number	:	386-427-5218

Provider Enumeration Date	:	10/07/2006
Last Update Date	:	01/28/2014

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