Provider Demographics
NPI:1255584025
Name:CARRINGTON, THOMAS WADE (RPA, RRA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WADE
Last Name:CARRINGTON
Suffix:
Gender:M
Credentials:RPA, RRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:305 W COURT ST
Mailing Address - Street 2:P.O. BOX 1296
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-4644
Mailing Address - Country:US
Mailing Address - Phone:731-285-2346
Mailing Address - Fax:731-884-8511
Practice Address - Street 1:305 W COURT ST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-4644
Practice Address - Country:US
Practice Address - Phone:731-285-2346
Practice Address - Fax:731-884-8511
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRA0000000002243U00000X
TNMDX00000050852471C3402X
KY10121065982471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography