Organization
DENNIS R THOMAS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS RUSSELL THOMAS PHYSICIAN (PRESIDENT)
(229) 247-9911
Entity
Organization
Contact information
Practice address
3374 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 247-9911
(229) 247-8844
Mailing address
3374 GREYSTONE WAY, VALDOSTA, GA 31605-1096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000262809E
—
GA
Enumeration date
01/09/2012
Last updated
01/09/2012
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