Individual
MR. THOMAS RANDALL HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1357 HEMBREE RD, SUITE 250, ROSWELL, GA 30076-5722
(770) 475-7550
(770) 343-9080
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001599
GA
Other
Enumeration date
06/30/2010
Last updated
01/20/2015
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