Individual
MR. THEODIS BUGGS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
750 TOWNPARK LN NW, KAISER PERMANENTE TOWNPARK MEDICAL CENTER, KENNESAW, GA 30144-5579
(205) 783-7830
(205) 783-7832
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(205) 783-7832
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
00009766
AL
207X00000X
Orthopaedic Surgery Physician
Primary
028947
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051521019
—
AL
01
—
51521019
BLUE CROSS BLUE SHIELD OF
AL
Enumeration date
09/20/2006
Last updated
01/10/2022
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