Provider Demographics
NPI:1871597435
Name:WALSH, THOMAS J (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:WALSH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:501 GREAT CIRCLE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228
Mailing Address - Country:US
Mailing Address - Phone:615-396-6800
Mailing Address - Fax:615-396-6801
Practice Address - Street 1:2723 NEW SALEM HWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128
Practice Address - Country:US
Practice Address - Phone:061-396-6850
Practice Address - Fax:615-396-6855
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-08-15
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Provider Licenses
StateLicense IDTaxonomies
TN2960207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018636Medicaid
TN10308I4169OtherTN MEDICARE
MI4293896Medicaid