Provider Demographics
NPI:1669470746
Name:AUSTIN, THOMAS E (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:AUSTIN
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 1:611 DRUID RD E STE 511
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3942
Mailing Address - Country:US
Mailing Address - Phone:727-601-4007
Mailing Address - Fax:
Practice Address - Street 1:611 DRUID RD E STE 511
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3942
Practice Address - Country:US
Practice Address - Phone:727-601-4007
Practice Address - Fax:727-250-1102
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG42097Medicare UPIN
FL32432AMedicare ID - Type Unspecified