MEDICARE: OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QX0100X	Occupational Medicine Clinic/Center
3	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1801921655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A.

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DRIVE
Second Line	:	SUITE 1200 WEST TOWER
City	:	ADDISON
State	:	TX
Zip	:	75001
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 SPRING PARK RD.
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216
Country	:	US
Telephone Number	:	904-399-5959
Fax Number	:	904-396-5777

Authorized Official
Title or Position	:	SENIOR VP / CHIEF MEDICAL OFFICER
Name	:	DR. TOM FOGARTY
Credential	:	M.D.
Telephone Number	:	972-364-8103

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/25/2008

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Directions to “OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST, P.A. ” Practice Location

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