Provance, Paul Thomas

Provance, Paul Thomas is an individual health care provider with primary practice located at James H Quillen Va Medical Center , Mountain Home TN 37684-4000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Provance, Paul Thomas can be contacted via phone (423) 926-1171.

Contact Information

Primary practice address
James H Quillen Va Medical Center Mountain Home TN 37684-4000
Phone: (423) 926-1171
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35.086268 Ohio
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD41434 Tennessee

Profile Details

NPI number 1760429740
LBN Legal business name Provance, Paul Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Nov 8th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760429740 NPPES
Tennessee MEDICAID 3825653
Tennessee MEDICAID 2571293

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