Provider Demographics
NPI:1073134904
Name:KERRIGAN, THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:KERRIGAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BEVERLY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3734
Mailing Address - Country:US
Mailing Address - Phone:703-288-7931
Mailing Address - Fax:708-273-5562
Practice Address - Street 1:1420 BEVERLY RD STE 300
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3734
Practice Address - Country:US
Practice Address - Phone:703-288-7931
Practice Address - Fax:708-273-5562
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012828762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology