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Individual
TOD H BETHEA
Active
Individual
TOD H BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042016
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000784638F
MEDICAID # QUICK CARE
GA
05
—
00784638E
—
GA
01
—
08CBCJS
QUICK CARE MEDICARE PIN
GA
Enumeration date
08/19/2005
Last updated
12/15/2020
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