Provider Demographics
NPI:1639135338
Name:KNOX, THOMAS A (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:KNOX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SCHOOL ST
Mailing Address - Street 2:LOVEJOY HEALTH CENTER SUITE 1
Mailing Address - City:ALBION
Mailing Address - State:ME
Mailing Address - Zip Code:04910
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 SCHOOL ST
Practice Address - Street 2:LOVEJOY HEALTH CENTER SUITE 1
Practice Address - City:ALBION
Practice Address - State:ME
Practice Address - Zip Code:04910
Practice Address - Country:US
Practice Address - Phone:207-437-9388
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS314103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KNMM4158Medicare ID - Type Unspecified