Provider Demographics
NPI:1497802052
Name:KLINNER, THOMAS ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:KLINNER
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 1:9203 LEE HWY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6458
Mailing Address - Country:US
Mailing Address - Phone:423-238-4700
Mailing Address - Fax:423-238-4747
Practice Address - Street 1:9203 LEE HWY STE 9
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6458
Practice Address - Country:US
Practice Address - Phone:423-238-4700
Practice Address - Fax:423-238-4747
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103351Medicaid
TNC72482Medicare UPIN
TN103351Medicaid