Individual
TIMOTHY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3651 WHEELER RD, AUGUSTA, GA 30909-6521
(706) 855-9860
(706) 860-7124
Mailing address
PO BOX 204097, AUGUSTA, GA 30907
(706) 855-9860
(706) 860-7124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN-CRNA123907
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN123907
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
437974607A
—
GA
05
—
GAN621
—
SC
01
—
P00385651
RAILROAD MEDICARE
GA
Enumeration date
02/26/2007
Last updated
03/09/2026
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