MEDICARE: DR. THOMAS DAVID GREENWELL JR. M.D.

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	174400000X	Specialist	MD0000012807	TN

General Provider Information

NPI Number	:	1013913474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS DAVID GREENWELL JR. M.D.

Provider Business Mailing Address
First Line	:	7606 CHAPEL CREEK PKWY N
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-2848
Country	:	US
Telephone Number	:	901-230-2869
Fax Number	:

Provider Business Practice Location Address
First Line	:	7606 CHAPEL CREEK PKWY N
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-2848
Country	:	US
Telephone Number	:	901-230-2869
Fax Number	:

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/19/2024

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