MEDICARE: DR. THOMAS CLARENCE SCHERICH D.O.

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	207Q00000X	Family Medicine Physician	3153	AZ

General Provider Information

NPI Number	:	1588604268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS CLARENCE SCHERICH D.O.

Provider Business Mailing Address
First Line	:	PO BOX 549
Second Line	:
City	:	CAMP VERDE
State	:	AZ
Zip	:	86322-0549
Country	:	US
Telephone Number	:	928-639-5550
Fax Number	:	928-639-5566

Provider Business Practice Location Address
First Line	:	460 FINNIE FLAT RD
Second Line	:
City	:	CAMP VERDE
State	:	AZ
Zip	:	86322
Country	:	US
Telephone Number	:	928-639-5550
Fax Number	:	928-639-5566

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	11/14/2008

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