Provider Demographics
NPI:1992504450
Name:THOMAS, ALSTON
Entity type:Individual
Prefix:
First Name:ALSTON
Middle Name:
Last Name:THOMAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SUNNY WAY
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:TN
Mailing Address - Zip Code:37029-9800
Mailing Address - Country:US
Mailing Address - Phone:931-619-9723
Mailing Address - Fax:
Practice Address - Street 1:302 TYSON AVE STE B
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4555
Practice Address - Country:US
Practice Address - Phone:931-619-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant