MEDICARE: DR. THU THAI M.D.

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	2084P0800X	Psychiatry Physician	ME 43166	FL

General Provider Information

NPI Number	:	1912114760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THU THAI M.D.

Provider Business Mailing Address
First Line	:	4064 MCLAUGHLIN DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-2759
Country	:	US
Telephone Number	:	850-894-6616
Fax Number	:

Provider Business Practice Location Address
First Line	:	4064 MCLAUGHLIN DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-2759
Country	:	US
Telephone Number	:	850-894-6616
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	01/25/2026

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