Provider Demographics
NPI:1891723284
Name:DEVLIN, THOMAS G (MD PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 GLENWOOD DR
Mailing Address - Street 2:SUITE 467 WEST
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1106
Mailing Address - Country:US
Mailing Address - Phone:423-698-3423
Mailing Address - Fax:423-698-1380
Practice Address - Street 1:721 GLENWOOD DR
Practice Address - Street 2:SUITE 467 WEST
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1106
Practice Address - Country:US
Practice Address - Phone:423-698-3423
Practice Address - Fax:423-698-1380
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH210122084N0400X
FLME1471202084N0400X
GA0422292084N0400X
TNMD00000281342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA3038284Medicaid
TN3026632Medicaid
GA00350908AMedicaid
3801224Medicare ID - Type Unspecified
GA3038284Medicaid