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Individual

JOHN PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
915 GORDON AVE, THOMASVILLE, GA 31792-6614
(229) 228-2762
Mailing address
130 N BROAD ST, THOMASVILLE, GA 31792-8132
(229) 228-6496

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35.092634
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
64243
GA

Other

Enumeration date
05/15/2007
Last updated
01/04/2012
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