Provider Demographics
NPI:1619053030
Name:WARWICK, THOMAS MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MARK
Last Name:WARWICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 KINGSTON PIKE
Mailing Address - Street 2:SUITE F
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5099
Mailing Address - Country:US
Mailing Address - Phone:865-693-1911
Mailing Address - Fax:865-693-1911
Practice Address - Street 1:8805 KINGSTON PIKE
Practice Address - Street 2:SUITE F
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5099
Practice Address - Country:US
Practice Address - Phone:865-693-1911
Practice Address - Fax:865-693-1911
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN001104111N00000X
MI002884111N00000X
FL0005962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3677209Medicaid
TN3677209Medicare ID - Type Unspecified
TN3677209Medicaid