Provider Demographics
NPI:1851433452
Name:PITMAN, TOM (MT)
Entity Type:Individual
Prefix:MR
First Name:TOM
Middle Name:
Last Name:PITMAN
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 N GOODLETT ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-2220
Mailing Address - Country:US
Mailing Address - Phone:901-761-7977
Mailing Address - Fax:
Practice Address - Street 1:166 N GOODLETT ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-2220
Practice Address - Country:US
Practice Address - Phone:901-761-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMT491175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath