Provider Demographics
NPI:1376994558
Name:MIDDLETON, THOMAS RUSSELL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RUSSELL
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 AIRLINE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4894
Mailing Address - Country:US
Mailing Address - Phone:901-867-8989
Mailing Address - Fax:901-867-8757
Practice Address - Street 1:6050 AIRLINE RD STE 106
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-4894
Practice Address - Country:US
Practice Address - Phone:901-867-8989
Practice Address - Fax:901-867-8757
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108152251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic