Provider Demographics
NPI:1588900724
Name:THOMAS, ERIC S (PT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30811
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-0811
Mailing Address - Country:US
Mailing Address - Phone:865-888-5431
Mailing Address - Fax:865-888-5432
Practice Address - Street 1:142 FAIRBANKS RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7000
Practice Address - Country:US
Practice Address - Phone:865-888-5431
Practice Address - Fax:865-888-5432
Is Sole Proprietor?:No
Enumeration Date:2012-12-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist