Provider Demographics
NPI:1568419398
Name:PRESSON, THOMAS LEMUEL JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEMUEL
Last Name:PRESSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 19368
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27619-9368
Mailing Address - Country:US
Mailing Address - Phone:919-787-8221
Mailing Address - Fax:919-789-4461
Practice Address - Street 1:3949 BROWNING PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6504
Practice Address - Country:US
Practice Address - Phone:919-787-8221
Practice Address - Fax:919-789-4461
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-014422085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA7641OtherMEDCOST
NC128X2OtherBLUECROSS BLUESHIELD
NC89128X2Medicaid
NC300121845OtherRAILROAD MEDICARE
NC16-57206OtherUNITED HEALTHCARE
NC16-00699OtherUNITED HEALTHCARE
NC300121844OtherRAILROAD MEDICARE
NC300133135OtherRAILROAD MEDICARE
NCA9264OtherMEDCOST
NC16-00156OtherUNITED HEALTHCARE
NCA9266OtherMEDCOST
NCB6913OtherMEDCOST
NCA7641OtherMEDCOST
NC2286709Medicare ID - Type Unspecified
NC89128X2Medicaid
NC300121845OtherRAILROAD MEDICARE