Provider Demographics
NPI:1275539975
Name:THOMAS, STEVEN M (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:THOMAS
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 1:632 MORRISON SPRINGS RD
Mailing Address - Street 2:STE 301
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-3402
Mailing Address - Country:US
Mailing Address - Phone:423-778-2020
Mailing Address - Fax:
Practice Address - Street 1:632 MORRISON SPRINGS RD
Practice Address - Street 2:STE 301
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-3402
Practice Address - Country:US
Practice Address - Phone:423-778-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD9966207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3189796Medicaid
B04398Medicare UPIN
TN3189796Medicaid