Provider Demographics
NPI:1104886399
Name:CABLE, THOMAS ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALLEN
Last Name:CABLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:325 MARKET ST
Mailing Address - Street 2:SUITE 202, LIFESTYLE CENTER
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-1226
Mailing Address - Country:US
Mailing Address - Phone:423-778-9470
Mailing Address - Fax:423-778-9471
Practice Address - Street 1:325 MARKET ST
Practice Address - Street 2:SUITE 202, LIFESTYLE CENTER
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1226
Practice Address - Country:US
Practice Address - Phone:423-778-9470
Practice Address - Fax:423-778-9471
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN27122207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4073904OtherBLUE CROSS/ BLUE SHIELD
TN27122OtherSTATE MEDICAL LICENSE
TNC83096Medicare UPIN