Provider Demographics
NPI:1083679682
Name:FIEBKE, THOMAS ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLEN
Last Name:FIEBKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 PARKSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0000
Mailing Address - Country:US
Mailing Address - Phone:865-777-5180
Mailing Address - Fax:865-777-5186
Practice Address - Street 1:10900 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1938
Practice Address - Country:US
Practice Address - Phone:865-777-5180
Practice Address - Fax:865-777-5186
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012085183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist