Individual
KATHRYN ANN THATCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4002 FOREST DR, STATESBORO, GA 30460-0001
(912) 478-5641
Mailing address
PO BOX 8043, STATESBORO, GA 30460-8043
(912) 478-5641
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161445499A
—
GA
Enumeration date
08/29/2006
Last updated
08/04/2011
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