Individual
DR. THOMAS TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 EXECUTIVE PARK DR, CLINTON, TN 37716
(865) 494-9241
(865) 494-0895
Mailing address
110 EXECUTIVE PARK DR, CLINTON, TN 37716-6876
(865) 494-9241
(865) 494-0895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038858
TN
207QS0010X
Sports Medicine (Family Medicine) Physician
038858
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000352900
—
FL
01
—
103I083671
MEDICARE PTAN UFP
TN
01
—
1522707
MEDICAID PTAN UFP
TN
05
—
1522707
—
TN
01
—
3373352
MEDICARE GRP UFP
TN
01
—
4278768
BCBS TN UFP
TN
01
—
P00923551
RR MEDICARE UFP
TN
Enumeration date
10/11/2006
Last updated
06/01/2018
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