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NPI Code Detail

MEDICARE: THOMAS D PAINE MD FACC

MEDICARE: THOMAS D PAINE MD FACC
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
1207RC0000XCardiovascular Disease PhysicianME87460FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710987268
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS D PAINE MD FACC
Provider Business Mailing Address
First Line : 1717 NORTH E STREET
Second Line : SUITE 333
City : PENSACOLA
State : FL
Zip : 32501
Country : US
Telephone Number : 850-444-1717
Fax Number : 850-857-1747
Provider Business Practice Location Address
First Line : 5151 N 9TH AVE
Second Line : SUITE 200
City : PENSACOLA
State : FL
Zip : 32504-8721
Country : US
Telephone Number : 850-857-1700
Fax Number : 850-857-1747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 01/23/2012

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