Provider Demographics
NPI:1184964413
Name:MIDDLETON, THOMAS PATRICK (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:MIDDLETON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5060 CALIFORNIA AVE
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0728
Mailing Address - Country:US
Mailing Address - Phone:661-616-0511
Mailing Address - Fax:805-203-5231
Practice Address - Street 1:5060 CALIFORNIA AVE
Practice Address - Street 2:10TH FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0728
Practice Address - Country:US
Practice Address - Phone:661-616-0511
Practice Address - Fax:805-203-5231
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-23
Last Update Date:2013-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11808103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist