MEDICARE: DWIGHT A TOWNSEND MD

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	2085B0100X	Body Imaging Physician	K4817	TX
2	2085R0202X	Diagnostic Radiology Physician	ME99052	FL
3	2085R0202X	Diagnostic Radiology Physician	81276	GA
4	2085R0202X	Diagnostic Radiology Physician	K4817	TX
5	2085R0202X	Diagnostic Radiology Physician	0101265572	VA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811981590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DWIGHT A TOWNSEND MD

Provider Business Mailing Address
First Line	:	19207 TERRA ROCK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-2343
Country	:	US
Telephone Number	:	361-548-1249
Fax Number	:

Provider Business Practice Location Address
First Line	:	19207 TERRA ROCK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78255-2343
Country	:	US
Telephone Number	:	361-548-1249
Fax Number	:

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	08/11/2023

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Directions to “ DWIGHT A TOWNSEND MD” Practice Location

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