Healthcare Provider Details

I. General information

NPI: 1841935335
Provider Name (Legal Business Name): THOMAS MALONE SNEAD III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N STATE OF FRANKLIN RD
JOHNSON CITY TN
37604-6056
US

IV. Provider business mailing address

13895 TEMIN AVE
ORLANDO FL
32827-7504
US

V. Phone/Fax

Practice location:
  • Phone: 423-439-7272
  • Fax:
Mailing address:
  • Phone: 334-444-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME181262
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: