Provider Demographics
NPI:1740223460
Name:THRASHER, BARTON BORG (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:BORG
Last Name:THRASHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:214 LAKEVIEW RD
Mailing Address - Street 2:SUITE 174
Mailing Address - City:SOMERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38068-9737
Mailing Address - Country:US
Mailing Address - Phone:901-465-9955
Mailing Address - Fax:901-465-9955
Practice Address - Street 1:214 LAKEVIEW RD
Practice Address - Street 2:SUITE 174
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068-9737
Practice Address - Country:US
Practice Address - Phone:901-465-9955
Practice Address - Fax:901-465-9955
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 023517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3895441Medicaid
TN3895441Medicaid