Individual
ABBY MARIE THAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 22ND AVE FL 3, MERIDIAN, MS 39301-3223
(601) 693-1055
Mailing address
PO BOX 749215, ATLANTA, GA 30374-9215
(901) 226-3186
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00222
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01680755
—
MS
01
—
PA00222
MISSISSIPPI MEDICAL LICENSE
MS
Enumeration date
09/16/2014
Last updated
10/31/2024
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