# TAMARA THORN DMSC, PA-C, LCSW PSYCHIATRIC PHYSICIAN ASSISTANT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TAMARA THORN DMSC, PA-C, LCSW PSYCHIATRIC PHYSICIAN ASSISTANT SERVICES
- **Other names:** THE TRAVELING PHYSICIAN ASSISTANT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1205671278
- **Legal business name:** TAMARA THORN DMSC, PA-C, LCSW PSYCHIATRIC PHYSICIAN ASSISTANT SERVICES
- **Authorized official:** DR. DR. TAMARA IDETTE THORN PA-C, LCSW, CAADC (OWNER, OPERATOR)
- **Authorized official phone:** (704) 898-7837

## Contact information

- **Practice address:** 45 LULLWATER DR UNIT 617, RICHMOND HILL, GA 31324-6612
- **Practice address phone:** (704) 898-7837
- **Mailing address:** PO BOX 2687, RICHMOND HILL, GA 31324-2687
- **Mailing address phone:** (912) 572-0358
- **Mailing address fax:** (912) 244-9958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2024
- **Last updated:** 08/14/2024