Provider Demographics
NPI:1235184300
Name:MITCHELL, THOMAS ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ROBERT
Last Name:MITCHELL
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 1:3370 SWEENEY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-9575
Mailing Address - Country:US
Mailing Address - Phone:615-790-8799
Mailing Address - Fax:
Practice Address - Street 1:TENNESSE VALLEY HEALTHCARE SYSTEM
Practice Address - Street 2:1310 24TH AVENUE SOUTH
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-225-4830
Practice Address - Fax:615-225-4831
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD17790207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3033199Medicaid
TN110071859OtherRAILROAD MEDICARE
TN3033192Medicaid
TN3059825OtherBLUE CROSS
TN265059755OtherCHAMPUS