Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 54093 | TN |
Y | 2084N0402X | Child Neurologist | 54093 | TN |
N | 2084N0600X | Clinical Neurophysiologist | 54093 | TN |
NPI | 1366607327 |
---|---|
Provider Name | Dr. Thomas A Ireland JR. |
First Address | Chattanooga, TN 37403-2147 |
Second Address | Chattanooga, TN 37403-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 14/06/2016 |