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Organization

C. THOMAS BEVILL III MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. C. THOMAS BEVILL III MD (OWNER)
(770) 386-1000
Entity
Organization

Contact information

Practice address
12 MEDICAL DR NE, CARTERSVILLE, GA 30121-8002
(770) 386-1000
(770) 386-9165
Mailing address
PO BOX 200185, CARTERSVILLE, GA 30120-9027
(770) 386-1000
(770) 386-9165

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
028143
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511I080035
MEDICARE ID
GA
Enumeration date
04/06/2007
Last updated
01/26/2018
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