Provider Demographics
NPI:1063525665
Name:DOVAN, THOMAS T (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
Last Name:DOVAN
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 1:2021 CHURCH ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-284-2000
Mailing Address - Fax:615-284-2003
Practice Address - Street 1:2004 HAYES ST STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2689
Practice Address - Country:US
Practice Address - Phone:615-324-1600
Practice Address - Fax:615-324-1661
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41881207X00000X, 207XS0106X
GA053135207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA863047310AMedicaid
TN3833142Medicare ID - Type Unspecified
GA863047310AMedicaid
H65259Medicare UPIN