Individual
DR. THOMAS M MAHON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1786 OAK RD, SNELLVILLE, GA 30078-2234
(770) 979-3456
(770) 979-7476
Mailing address
1786 OAK RD, SNELLVILLE, GA 30078-2234
(770) 979-3456
(770) 979-7476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001585
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2200336
UNITED HEALTHCARE
GA
01
—
52636582
BC&BS
GA
05
—
740334621A
—
GA
Enumeration date
08/19/2005
Last updated
09/05/2012
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