Provider Demographics
NPI:1558330241
Name:CONWAY, THOMAS W (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:CONWAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:434 4TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3746
Mailing Address - Country:US
Mailing Address - Phone:423-623-0640
Mailing Address - Fax:423-623-7615
Practice Address - Street 1:434 4TH ST
Practice Address - Street 2:SUITE 310
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3746
Practice Address - Country:US
Practice Address - Phone:423-623-0640
Practice Address - Fax:423-623-7615
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2020-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD016692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA98090Medicare UPIN
TN3016998Medicare UPIN