Provider Demographics
NPI:1750423505
Name:MERIWETHER, THOMAS WHITE (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WHITE
Last Name:MERIWETHER
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 1:4900 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-3314
Mailing Address - Country:US
Mailing Address - Phone:901-767-5451
Mailing Address - Fax:901-682-8971
Practice Address - Street 1:4900 LAKE DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-3314
Practice Address - Country:US
Practice Address - Phone:901-767-5451
Practice Address - Fax:901-682-8971
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
TNMD00003900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine