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THOMAS TAYLOR FISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME70634
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009962800
AL
01
050049613
MEDICARE RAILROAD
FL
01
31866
BLUE CROSS BLUE SHIELD
FL
05
379978600
FL
01
591-36248
BLUE CROSS BLUE SHIELD
AL
01
Z188
HEALTH FIRST NETWORK
FL
Enumeration date
12/30/2005
Last updated
11/14/2011
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