Provider Demographics
NPI:1689678922
Name:GADIENT, THOMAS M (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:GADIENT
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 13059
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4021
Mailing Address - Country:US
Mailing Address - Phone:812-485-1220
Mailing Address - Fax:812-485-8544
Practice Address - Street 1:920 S HEBRON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-4086
Practice Address - Country:US
Practice Address - Phone:812-473-1111
Practice Address - Fax:812-473-0911
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032887A208800000X
KY22291208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64222912Medicaid
C74529Medicare UPIN
KY0611401Medicare ID - Type Unspecified
KY64222912Medicaid
IN532250KMedicare PIN
C74529Medicare UPIN