Provider Demographics
NPI:1053631093
Name:WEBSTER, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TMC CAMP ATTERBURY
Mailing Address - Street 2:PO BOX 5000
Mailing Address - City:EDINBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:46124-5000
Mailing Address - Country:US
Mailing Address - Phone:812-526-1120
Mailing Address - Fax:812-526-1178
Practice Address - Street 1:TMC CAMP ATTERBURY
Practice Address - Street 2:BUILDING 2
Practice Address - City:EDINBURGH
Practice Address - State:IN
Practice Address - Zip Code:46124-5000
Practice Address - Country:US
Practice Address - Phone:812-526-1120
Practice Address - Fax:812-526-1178
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056373A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine