Individual
DR. TEDRA CAROLYN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
730 GLYNN ST S, FAYETTEVILLE, GA 30214-2050
(770) 460-3650
Mailing address
PO BOX 4363, MACON, GA 31208-4363
(478) 787-4266
(478) 787-4199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
89557
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003255700A
—
GA
Enumeration date
04/26/2018
Last updated
08/21/2025
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