Individual
DR. MICHAEL THOMAS ANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
700 W FOREST AVE STE 200, JACKSON, TN 38301-3940
(731) 541-9490
(731) 541-9486
Mailing address
1804 HIGHWAY 45 BYP STE 604, JACKSON, TN 38305-4403
(731) 660-7971
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1273
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3681371
—
TN
01
—
4182427
BCBS
TN
01
—
700007375
RAILROAD MEDICARE
TN
Enumeration date
09/15/2006
Last updated
07/21/2022
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