Provider Demographics
NPI:1477544815
Name:ALDERSON, THOMAS PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PAUL
Last Name:ALDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5009
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-5009
Mailing Address - Country:US
Mailing Address - Phone:615-221-3642
Mailing Address - Fax:615-371-4600
Practice Address - Street 1:1327 STELLY LANE
Practice Address - Street 2:SUITE 2
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663
Practice Address - Country:US
Practice Address - Phone:337-528-7898
Practice Address - Fax:337-528-7427
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07139R208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1900198OtherUNITED HEALTHCARE
LA340004858OtherRAILROAD MEDICARE
LA41480555490OtherBLUE CROSS BLUE SHIELD
LALA6002281OtherTRICARE
LA1361674Medicaid
LAB63487Medicare UPIN
LALA6002281OtherTRICARE