Provider Demographics
NPI:1447275359
Name:NOLIN, SHON PATRICK (DO)
Entity type:Individual
Prefix:DR
First Name:SHON
Middle Name:PATRICK
Last Name:NOLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2522
Mailing Address - Country:US
Mailing Address - Phone:931-723-2036
Mailing Address - Fax:
Practice Address - Street 1:1608 MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2522
Practice Address - Country:US
Practice Address - Phone:931-723-2036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001301207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF73752Medicare UPIN
3370244OtherGROUP PTAN
TNF73752Medicare UPIN