Provider Demographics
NPI:1588622831
Name:GASKIN, THOMAS ALLEN III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLEN
Last Name:GASKIN
Suffix:III
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 1:833 PRINCETON AVE SW
Mailing Address - Street 2:STE 200F
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211
Mailing Address - Country:US
Mailing Address - Phone:205-776-8600
Mailing Address - Fax:205-776-8603
Practice Address - Street 1:833 PRINCETON AVE SW
Practice Address - Street 2:STE 200F
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211
Practice Address - Country:US
Practice Address - Phone:205-776-8600
Practice Address - Fax:205-776-8603
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005337174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51534380OtherBCBS
AL051534380Medicaid
AL51534380OtherBCBS
AL051534380Medicaid