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Organization
THOMAS R. MAYCOCK
Active
Organization
THOMAS R. MAYCOCK
Active
Other names
WALDO COUNTY FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS ROLAND MAYCOCK M.D. (OWNER)
(207) 338-1120
Entity
Organization
Contact information
Practice address
9 FAHEY ST, BELFAST, ME 04915-6028
(207) 338-1120
(207) 338-1691
Mailing address
9 FAHEY ST, BELFAST, ME 04915-6028
(207) 338-1120
(207) 338-1691
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008970
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012002
ANTHEM BC BS
ME
01
—
080086258
RR MEDICARE
ME
05
—
118460000
—
ME
05
—
314800099
—
ME
01
—
E000363
CHAMPUS
ME
Enumeration date
05/09/2007
Last updated
09/15/2011
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