Individual
NICHOLAS P THORNTON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 E EMORY RD, POWELL, TN 37849-4016
(865) 938-3627
Mailing address
1275 DICK LONAS RD UNIT 101, KNOXVILLE, TN 37909-1383
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37029
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3889692
—
TN
01
—
P0155783
RR MEDICARE PIN
TN
Enumeration date
06/10/2006
Last updated
04/27/2020
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