Individual
DR. THOMAS GARLAND MAGRUDER V
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
135 W RAVINE RD, STE 5B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465
Mailing address
PO BOX 535744, ATLANTA, GA 30353-5510
(844) 294-5114
(865) 691-0843
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
51109
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063773810
—
VA
05
—
Q021941
—
TN
Enumeration date
06/07/2012
Last updated
04/12/2017
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