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NPI Code Detail

MEDICARE: DR. MATTHEW SHAWN THOMAS DO

MEDICARE: DR. MATTHEW SHAWN THOMAS DO
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
1207Q00000XFamily Medicine Physician0102201997VA
2207Q00000XFamily Medicine PhysicianDO0000002329TN
3208D00000XGeneral Practice Physician2329TN

General Provider Information

NPI Number : 1801862313
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW SHAWN THOMAS DO
Provider Business Mailing Address
First Line : 836 LAKE POINT DR
Second Line :
City : PINEY FLATS
State : TN
Zip : 37686-4524
Country : US
Telephone Number : 954-336-7665
Fax Number :
Provider Business Practice Location Address
First Line : 3114 BROWNS MILL RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1417
Country : US
Telephone Number : 423-631-0432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2006
Last Update Date : 02/25/2026

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