Provider Demographics
NPI:1831797612
Name:LOVINGOOD, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LOVINGOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 S HALL RD
Mailing Address - Street 2:
Mailing Address - City:ALCOA
Mailing Address - State:TN
Mailing Address - Zip Code:37701-2642
Mailing Address - Country:US
Mailing Address - Phone:865-977-7441
Mailing Address - Fax:
Practice Address - Street 1:244 S HALL RD
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2642
Practice Address - Country:US
Practice Address - Phone:865-977-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN433471835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN43347OtherTENNESSE BOARD OF PHARMACY