Individual
THOMAS B GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1551 DOCTORS DR, BUILDING 200, LAGRANGE, GA 30240-4139
(706) 884-2641
(706) 884-2353
Mailing address
1551 DOCTORS DR, BUILDING 200, LAGRANGE, GA 30240-4139
(706) 884-2641
(706) 884-2353
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
027553
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000304961A
—
GA
Enumeration date
09/14/2005
Last updated
09/30/2019
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