Provider Demographics
NPI:1285819367
Name:MEGUIAR, THOMAS MICHAEL (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MICHAEL
Last Name:MEGUIAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:M
Other - Last Name:MEGUIAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:103 WILTON SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-6405
Mailing Address - Country:US
Mailing Address - Phone:423-487-2222
Mailing Address - Fax:423-623-7787
Practice Address - Street 1:103 WILTON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-6405
Practice Address - Country:US
Practice Address - Phone:423-487-2222
Practice Address - Fax:423-623-7787
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP1279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical