Provider Demographics
NPI:1356881213
Name:THOMAS RAULERSON MD AND FARM INC
Entity type:Organization
Organization Name:THOMAS RAULERSON MD AND FARM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RAULERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-283-4449
Mailing Address - Street 1:926 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4140
Mailing Address - Country:US
Mailing Address - Phone:352-575-0766
Mailing Address - Fax:352-505-4046
Practice Address - Street 1:926 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4140
Practice Address - Country:US
Practice Address - Phone:352-379-1049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty