Provider Demographics
NPI:1841069804
Name:THOMAS, DORIS BREWSTER (RD,LDN)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:BREWSTER
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-8214
Mailing Address - Country:US
Mailing Address - Phone:865-250-5907
Mailing Address - Fax:
Practice Address - Street 1:6336 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-5938
Practice Address - Country:US
Practice Address - Phone:865-888-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN550133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered