Provider Demographics
NPI:1225052194
Name:TIGHE, THOMAS VINCENT (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:VINCENT
Last Name:TIGHE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 KIRKWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5121
Mailing Address - Country:US
Mailing Address - Phone:828-754-0101
Mailing Address - Fax:828-757-0402
Practice Address - Street 1:902 KIRKWOOD AVE NW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5121
Practice Address - Country:US
Practice Address - Phone:828-754-0101
Practice Address - Fax:828-757-0402
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01735207PH0002X
CA20A5921207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2016-01735OtherMEDICAL LICENSE
CA00AX59210Medicaid
CA00AX59210Medicaid