Provider Demographics
NPI:1871680348
Name:WILLIAMS, THOMAS H (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1 S SCHOOL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6014
Practice Address - Country:US
Practice Address - Phone:941-309-7000
Practice Address - Fax:941-308-8508
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0045454174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1193531OtherWELLCARE
FLP103667OtherFREEDOM HEALTH
FL43090100Medicaid
FL0187522OtherCIGNA
FLP01078299OtherRAILROAD MEDICARE
FL4311273OtherAETNA
FLP513699OtherOPTIMUM
FL212202OtherAVMED
FL00261OtherUNIVERSAL
FLP513699OtherOPTIMUM
FLP01078299OtherRAILROAD MEDICARE
FL1193531OtherWELLCARE
FL4311273OtherAETNA