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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