Provider Demographics
NPI:1740233378
Name:FRIDDELL, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:FRIDDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2817 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2548
Mailing Address - Country:US
Mailing Address - Phone:615-883-6545
Mailing Address - Fax:615-889-7886
Practice Address - Street 1:2817 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2548
Practice Address - Country:US
Practice Address - Phone:615-883-6545
Practice Address - Fax:615-889-7886
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN4997207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB01584OtherHEALTHSPRING
TN0009817OtherBCBS
TNP2714869OtherFIRST HEALTH
TN319720Medicaid
TN0009817OtherTENNCARE
TN4082123OtherAETNA
TN2565640OtherCIGNA
TN3129724Medicare PIN
TN0009817OtherBCBS