Provider Demographics
NPI:1114254083
Name:ELMORE, THOMAS DEES (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DEES
Last Name:ELMORE
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 1:40 KINGSTON CV
Mailing Address - Street 2:
Mailing Address - City:EADS
Mailing Address - State:TN
Mailing Address - Zip Code:38028-3307
Mailing Address - Country:US
Mailing Address - Phone:901-619-9364
Mailing Address - Fax:901-448-4701
Practice Address - Street 1:40 KINGSTON CV
Practice Address - Street 2:
Practice Address - City:EADS
Practice Address - State:TN
Practice Address - Zip Code:38028-3307
Practice Address - Country:US
Practice Address - Phone:901-619-9364
Practice Address - Fax:901-448-4701
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist