Provider Demographics
NPI:1285951194
Name:CHAMBERLAIN, THOMAS J (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:CHAMBERLAIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF FLORIDA DEPARTMENT OF CHFM
Mailing Address - Street 2:625 SW 4TH AVE.
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601
Mailing Address - Country:US
Mailing Address - Phone:352-392-4541
Mailing Address - Fax:352-392-7766
Practice Address - Street 1:UNIVERSITY OF FLORIDA DEPARTMENT OF CHFM
Practice Address - Street 2:625 SW 4TH AVE.
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601
Practice Address - Country:US
Practice Address - Phone:352-392-4541
Practice Address - Fax:352-392-7766
Is Sole Proprietor?:No
Enumeration Date:2010-05-02
Last Update Date:2011-06-23
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Provider Licenses
StateLicense IDTaxonomies
FL14709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14709OtherTRAINING LICENSE