Individual
FRED GODWIN THOMASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5515 SHELBY OAKS DR, MEMPHIS, TN 38134-7316
(901) 252-7718
(901) 252-7680
Mailing address
5515 SHELBY OAKS DR, MEMPHIS, TN 38134-7316
(901) 252-7718
(901) 252-7680
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
12324
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011150
—
MS
05
—
0070712
—
MS
05
—
3183887
—
TN
Enumeration date
08/08/2006
Last updated
07/09/2007
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