Provider Demographics
NPI:1922278126
Name:THOMAS, MICHAEL AUSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AUSTON
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 DOOLITTLE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-1139
Mailing Address - Country:US
Mailing Address - Phone:615-563-7273
Mailing Address - Fax:615-563-1202
Practice Address - Street 1:324 DOOLITTLE RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1139
Practice Address - Country:US
Practice Address - Phone:615-563-7273
Practice Address - Fax:615-563-1202
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 43772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01249054OtherAMERIGROUP/TENNCARE
TN1510093Medicaid
4192016OtherBCBST
4192016OtherBCBST