Provider Demographics
NPI:1285844902
Name:FOTOPOULOS, THOMAS JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:FOTOPOULOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8446 GARDENS CIR
Mailing Address - Street 2:9
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3066
Mailing Address - Country:US
Mailing Address - Phone:941-773-4508
Mailing Address - Fax:
Practice Address - Street 1:8446 GARDENS CIR
Practice Address - Street 2:9
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3066
Practice Address - Country:US
Practice Address - Phone:941-773-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8476204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM