Healthcare Provider Details

I. General information

NPI: 1033169891
Provider Name (Legal Business Name): THOMAS WILLIAM MACLENNAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TOWNSHIP LINE ROAD SUITE 150
YARDLEY PA
19067-5567
US

IV. Provider business mailing address

777 TOWNSHIP LINE ROAD SUITE 150
YARDLEY PA
19067-5567
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-3360
  • Fax: 215-860-3362
Mailing address:
  • Phone: 215-860-3360
  • Fax: 215-860-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD494386
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: