Provider Demographics
NPI:1164511150
Name:ESSER, THOMAS J (PAC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:ESSER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4511
Mailing Address - Country:US
Mailing Address - Phone:865-633-9469
Mailing Address - Fax:865-633-9474
Practice Address - Street 1:900 E WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4511
Practice Address - Country:US
Practice Address - Phone:865-633-9469
Practice Address - Fax:865-633-9474
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00995363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P76649Medicare UPIN
TN3661065Medicare ID - Type UnspecifiedCIGNA GOVERNMENT SERVICES