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Organization
TLC OF GEORGIA LLC
Active
Organization
TLC OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS SHELLY (VP & GENERAL MANAGER)
(615) 425-4200
Entity
Organization
Contact information
Practice address
4321 HARTLEY BRIDGE RD, MACON, GA 31216-5641
(478) 788-2046
(478) 788-2047
Mailing address
2620 ELM HILL PIKE, NASHVILLE, TN 37214-3108
(615) 425-4200
(615) 891-5244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750677241
GROUP NPI
GA
Enumeration date
09/28/2016
Last updated
10/22/2025
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