Provider Demographics
NPI:1033214432
Name:WHITWORTH, THOMAS CLAYTON (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CLAYTON
Last Name:WHITWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37236
Mailing Address - Country:US
Mailing Address - Phone:615-284-5071
Mailing Address - Fax:615-284-3349
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:SUITE #326 BAPTIST HOSPITAL
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236
Practice Address - Country:US
Practice Address - Phone:615-284-5071
Practice Address - Fax:615-284-3349
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0068462080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCSP671OtherCIGNA
TN150480OtherBCBST
TN3161373Medicaid
TN150480OtherBCBST
3161374Medicare ID - Type Unspecified