Provider Demographics
NPI:1831420058
Name:THOMAS E AUSTIN MD PA
Entity type:Organization
Organization Name:THOMAS E AUSTIN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/MEDICAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:727-442-7811
Mailing Address - Street 1:611 DRUID RD E
Mailing Address - Street 2:SUITE 511
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3959
Mailing Address - Country:US
Mailing Address - Phone:727-442-0500
Mailing Address - Fax:727-442-0535
Practice Address - Street 1:611 DRUID RD E
Practice Address - Street 2:SUITE 511
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3959
Practice Address - Country:US
Practice Address - Phone:727-442-0500
Practice Address - Fax:727-442-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262175400Medicaid