1447204623 NPI number — THOMAS R WARNER PHD PLLC

Table of content: (NPI 1447204623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447204623 NPI number — THOMAS R WARNER PHD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS R WARNER PHD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447204623
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 KINDY FOREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28739-8847
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-606-0988
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
244 5TH AVE W STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28739-4302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-606-0988
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WARNER
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
CLINICAL PSYCHOLOGIST
Authorized Official Telephone Number:
828-290-7083

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  LA888 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)