MEDICARE: DR. THOMAS J DEMARO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	18271	FL
2	207Q00000X	Family Medicine Physician	1927	TN
3	207P00000X	Emergency Medicine Physician	1927	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053350363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS J DEMARO D.O.

Provider Business Mailing Address
First Line	:	5823 APPLE VALLEY DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37924-3115
Country	:	US
Telephone Number	:	561-334-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	5823 APPLE VALLEY DR
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37924-3115
Country	:	US
Telephone Number	:	561-334-3774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	11/03/2021

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