Individual
DR. JAMES DERRYL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
198 SW BROAD ST, JESUP, GA 31545-1101
(912) 530-6000
(912) 530-6044
Mailing address
198 SW BROAD ST, JESUP, GA 31545-1101
(912) 530-6000
(912) 530-6044
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1256
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00461876B
—
GA
05
—
00461876D
—
GA
Enumeration date
11/22/2006
Last updated
03/09/2010
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