Provider Demographics
NPI:1093959181
Name:THORNHILL, CHAD ALAN (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:ALAN
Last Name:THORNHILL
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:PO BOX 15004
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-5004
Mailing Address - Country:US
Mailing Address - Phone:865-541-8895
Mailing Address - Fax:865-633-4808
Practice Address - Street 1:2100 CLINCH AVENUE SUITE 420
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916
Practice Address - Country:US
Practice Address - Phone:865-824-0083
Practice Address - Fax:865-521-2911
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN540072080P0206X
SC866062080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ022600Medicaid