Individual
DR. THOMAS ROBERT AUSTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1370 13TH AVE S, SUITE 116, JACKSONVILLE BEACH, FL 32250-3206
(904) 247-3858
(904) 247-7079
Mailing address
11945 SAN JOSE BLVD, BLDG 300, JACKSONVILLE, FL 32223-1613
(904) 396-1725
(904) 399-1717
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME95091
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270661000
—
FL
05
—
289542326A
—
GA
01
—
2922220
CIGNA
FL
01
—
294577
AVMED
FL
01
—
4516825
AETNA
FL
01
—
48980
BLUE CROSS BLUE SHIELD
FL
01
—
P00722976
RAILROAD MEDICARE
—
Enumeration date
06/20/2006
Last updated
06/22/2011
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