Individual
DR. MARK E. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9390 THE LANDING DR, DOUGLASVILLE, GA 30135-7120
(770) 947-1112
Mailing address
9390 THE LANDING DR, DOUGLASVILLE, GA 30135-7120
(770) 947-1112
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
57599
GA
207Q00000X
Family Medicine Physician
Primary
57599
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529328395A
—
GA
05
—
529328395B
—
GA
01
—
P00333870
RAILROAD MEDICARE
GA
Enumeration date
07/05/2006
Last updated
11/01/2011
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