Individual
TOM K STATHOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1410 TUSCULUM BLVD STE 1500, GREENEVILLE, TN 37745-5810
(423) 638-2270
(423) 638-2205
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036098988
IL
207RC0000X
Cardiovascular Disease Physician
Primary
73862
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036098988
STATE LICENSE
IL
01
—
1740231505
NPI GROUP PRACTICE
IL
Enumeration date
05/23/2006
Last updated
01/05/2026
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