Provider Demographics
NPI:1578552220
Name:QUIGLEY, THOMAS ALBERT III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALBERT
Last Name:QUIGLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44 BARKLEY CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7530
Mailing Address - Country:US
Mailing Address - Phone:239-985-7171
Mailing Address - Fax:239-985-7118
Practice Address - Street 1:6091 S POINTE BLVD
Practice Address - Street 2:
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4899
Practice Address - Country:US
Practice Address - Phone:239-985-7171
Practice Address - Fax:239-985-7118
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0053984207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063625800Medicaid
FL07482OtherBCBS
D61516Medicare UPIN
07482Medicare PIN