Provider Demographics
NPI:1346233426
Name:ROWE, THOMAS DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DANIEL
Last Name:ROWE
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:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85147-0001
Mailing Address - Country:US
Mailing Address - Phone:602-528-1200
Mailing Address - Fax:602-528-1255
Practice Address - Street 1:483 W SEED FARM RD
Practice Address - Street 2:
Practice Address - City:SACATON
Practice Address - State:AZ
Practice Address - Zip Code:85147-5000
Practice Address - Country:US
Practice Address - Phone:602-528-1200
Practice Address - Fax:602-528-1255
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18469207Q00000X
OH35080919R207Q00000X
AZ55172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2326816Medicaid
4082151Medicare ID - Type Unspecified
OH2326816Medicaid