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Individual

DR. STUART JACKSON THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1077 BAXTER ST, ATHENS, GA 30606-3767
(706) 549-7757
(706) 549-4186
Mailing address
1077 BAXTER ST, ATHENS, GA 30606-3767
(706) 549-7757
(706) 549-4186

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GA1062
GA
152WS0006X
Sports Vision Optometrist
GA 1062
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00314388A
GA
Enumeration date
02/13/2006
Last updated
12/09/2013
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