Individual
THOMAS D FAUSETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 N PARRISH AVE, ADEL, GA 31620
(229) 896-7007
(229) 896-7627
Mailing address
707 N PARRISH AVE, ADEL, GA 31620
(229) 896-7007
(229) 896-7627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046090
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00801754F
—
GA
Enumeration date
11/13/2006
Last updated
01/20/2010
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