Individual
THOMAS S BACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3905 BROOKSIDE PKWY STE 202, ALPHARETTA, GA 30022-4425
(770) 751-9131
(770) 751-9132
Mailing address
3905 BROOKSIDE PKWY STE 202, ALPHARETTA, GA 30022-4425
(770) 751-9131
(770) 751-9132
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
030711
GA
207RC0000X
Cardiovascular Disease Physician
Primary
030711
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110033309
RAILROAD MEDICARE
GA
01
—
4216134
AETNA
GA
01
—
484268
BCBS
GA
01
—
TAX ID NUMBER
UNITED HEALTHCARE
GA
Enumeration date
05/24/2005
Last updated
02/23/2023
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