Provider Demographics
NPI:1447244710
Name:STENNETT, THOMAS R III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:STENNETT
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:436 CLAIRMONT CT STE 105
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1765
Mailing Address - Country:US
Mailing Address - Phone:804-748-9071
Mailing Address - Fax:804-768-8626
Practice Address - Street 1:12801 IRON BRIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1669
Practice Address - Country:US
Practice Address - Phone:804-748-9071
Practice Address - Fax:804-768-8626
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2018-01-22
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Provider Licenses
StateLicense IDTaxonomies
VA0101-034416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA011841OtherANTHEM
VA56513OtherSOUTHERN HEALTH
VA000010672OtherCIGNA