Provider Demographics
NPI:1477506475
Name:SPLAN, THOMAS PAUL (MD,)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:PAUL
Last Name:SPLAN
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 1:202 TIDES RUN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-4339
Mailing Address - Country:US
Mailing Address - Phone:757-880-4705
Mailing Address - Fax:757-880-4705
Practice Address - Street 1:202 TIDES RUN
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-4339
Practice Address - Country:US
Practice Address - Phone:757-880-4705
Practice Address - Fax:757-880-4705
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031028207RP1001X
MI4301030220207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10097096OtherOPTIMA HEALTH
VAPAROtherVIRGINIA HEALTH NETWORK
VA-122OtherTRICARE/CHAMPUS
VA1477506475Medicaid
VAPAROtherAETNA
VA1477506475OtherCOVENTRY HEALTH NETWORK
NC890616TMedicaid
VAPAROtherUSA MANAGED CARE
VAPAROtherMULTIPLAN
VA1477506475OtherUNITED HEALTHCARE
VA1477506475OtherVIRGINIA PREMIER HEALTH PLAN
VA477642OtherANTHEM BC/BS
VAPAROtherCORVEL
VAPAROtherCIGNA
VAA36147Medicare UPIN
VA-122OtherTRICARE/CHAMPUS
VA1477506475OtherCOVENTRY HEALTH NETWORK