Healthcare Provider Details

I. General information

NPI: 1760433817
Provider Name (Legal Business Name): THOMAS KENNETH WARCUP D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 TOLL GATE RD STE 108
WARWICK RI
02886-4326
US

IV. Provider business mailing address

2220 PLAINFIELD PIKE
CRANSTON RI
02921-2031
US

V. Phone/Fax

Practice location:
  • Phone: 919-552-8911
  • Fax:
Mailing address:
  • Phone: 401-585-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO 00533
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: