Provider Demographics
NPI:1447326038
Name:HABIGER, THOMAS G (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:HABIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 W THUNDERBIRD RD.
Mailing Address - Street 2:SUITE F1
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4632
Mailing Address - Country:US
Mailing Address - Phone:602-938-6960
Mailing Address - Fax:602-938-6069
Practice Address - Street 1:5620 W THUNDERBIRD RD
Practice Address - Street 2:SUITE G2
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4636
Practice Address - Country:US
Practice Address - Phone:602-938-6960
Practice Address - Fax:602-938-6069
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9H452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202530747Medicaid
AZZ120652Medicare PIN
MO202530747Medicaid
AZZ120653Medicare PIN
MO222013268Medicare ID - Type UnspecifiedMO MDCR #