Provider Demographics
NPI:1689869224
Name:SARTAIN, THOMAS KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KEITH
Last Name:SARTAIN
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 1:1028 W MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3352
Mailing Address - Country:US
Mailing Address - Phone:615-443-0300
Mailing Address - Fax:
Practice Address - Street 1:1028 W MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3352
Practice Address - Country:US
Practice Address - Phone:615-443-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4023535OtherBCBS TN
TNU27318Medicare UPIN
TN4023535OtherBCBS TN