Provider Demographics
NPI:1720080286
Name:THOMAS, ALBERT EDWARD III (DC)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:EDWARD
Last Name:THOMAS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 CENTRAL CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3153
Mailing Address - Country:US
Mailing Address - Phone:615-678-8745
Mailing Address - Fax:615-818-0758
Practice Address - Street 1:1307 CENTRAL CT
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3153
Practice Address - Country:US
Practice Address - Phone:615-678-8745
Practice Address - Fax:615-818-0758
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4082367OtherBCBS
TN3679776Medicare PIN
U71293Medicare UPIN