Provider Demographics
NPI:1033188230
Name:PARKER, TOM L (HIS)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:L
Last Name:PARKER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 SYCAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0847
Mailing Address - Country:US
Mailing Address - Phone:865-675-7605
Mailing Address - Fax:
Practice Address - Street 1:1550 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2153
Practice Address - Country:US
Practice Address - Phone:423-581-8554
Practice Address - Fax:423-254-1656
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN682237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist