Organization Name: | THOMAS C PRINCE JR MD INC |
NPI Number: | 1174532758 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS CHAFER PRINCE (OWNER) |
Mailing Address: | 2001 Laurel Ave Suite 405 Knoxville |
State: | TN US |
Postal Code: | 379161810 |
Phone Number: | 8655225101 |
Fax Number: | 8655411949 |
NPI Enumeration Date: | 08/05/2006 |
NPI Last Update Date: | 12/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |