Provider Demographics
NPI:1689731028
Name:THOMAS P. CHU, M.D., P.C.
Entity Type:Organization
Organization Name:THOMAS P. CHU, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-755-2511
Mailing Address - Street 1:520 TRINITY CREEK CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2279
Mailing Address - Country:US
Mailing Address - Phone:901-755-2511
Mailing Address - Fax:901-758-1965
Practice Address - Street 1:520 TRINITY CREEK CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-2279
Practice Address - Country:US
Practice Address - Phone:901-755-2511
Practice Address - Fax:901-758-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000016690207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0158276OtherBLUE CROSS BLUE SHIELD
TN2687986OtherCIGNA
TNE67017Medicare UPIN
TN0158276OtherBLUE CROSS BLUE SHIELD